ArticleJournal of orthopaedic case reports2026
Platelet-Rich Plasma Augmentation of Osteosynthesis in Femoral Neck Fractures: A Prospective Comparative Study Demonstrating Accelerated Union and Improved Function.
Article in Journal of orthopaedic case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Femoral neck fractures remain a major challenge in orthopedic trauma because the tenuous intracapsular blood supply predisposes to non-union and avascular necrosis even after mechanically sound fixation. Internal fixation is the standard head-preserving option in younger adults, yet biological failure persists. This study aimed to determine whether supplementing conventional osteosynthesis with autologous platelet-rich plasma (PRP) accelerates bone healing and improves functional recovery. Materials and Methods: In this prospective comparative study, 60 patients aged 18-60 years with acute femoral neck fractures were allocated equally to two groups. Group A (n = 30) underwent closed reduction and internal fixation with three cannulated cancellous screws augmented by intraoperative PRP injection through the screw cannulations; Group B (n = 30) received identical screw fixation alone. The groups were comparable in demographics, injury mechanism, and Garden and Pauwels classifications. Outcomes assessed over a minimum 1-year follow-up were time to radiological union, time to full weight-bearing, functional recovery by the Harris Hip Score (HHS), pain by the Visual Analog Scale (VAS), and post-operative complications. Results: PRP augmentation significantly accelerated healing. Radiological union was achieved at a mean of 3.54 ± 0.32 months in Group A versus 4.03 ± 0.47 months in Group B (P < 0.0001), permitting earlier full weight-bearing (3.58 ± 0.39 vs. 4.19 ± 0.54 months; P < 0.0001). The PRP group reached a higher final mean HHS (91.03 ± 1.38 vs. 88.73 ± 2.18; P < 0.0001). Final VAS scores did not differ significantly between groups (4.43 ± 0.50 vs. 4.70 ± 0.70; P = 0.09). Complication, non-union, and avascular necrosis rates requiring revision were low and comparable between groups. Conclusion: Autologous PRP is a safe and effective biological adjunct to internal fixation of femoral neck fractures. It shortens the time to union and to full weight-bearing and improves functional hip recovery without increasing surgical complications, and merits consideration as a routine addition to head-preserving osteosynthesis.
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