Does injectable platelet-rich fibrin enhance healing in intracapsular femoral neck fractures?: A preliminary study

Objectives Intracapsular femoral neck fractures remain enigmatic owing to their propensity to result in non-union despite optimum internal fixation. Researchers have tried various therapeutic options as they strive to reduce the chances of non-union. In the present article, we studied the radiological and clinical outcomes of using injectable platelet rich fibrin (iPRF) at the fracture site during internal fixation in intracapsular femoral neck fractures. Material and Methods We prospectively studied 22 cases of femoral neck fractures between 18-55 years that underwent multiple cannulated lag screws fixation after closed reduction. They were randomized into two groups in an odd-even number fashion. iPRF was prepared from autologous blood and injected at the fracture site during internal fixation in group A patients. Group B patients received standard internal fixation surgery without iPRF. There was a 2 year follow-up to assess radiological and clinical outcomes. Results The difference in age, gender, and duration since the injury between the groups was not significant statistically (p>0.05). Mean Pauwels angles were 55.4° (range; 41° to 66°) and 45.7° (range; 25° to 60°) for groups A and B, respectively (p<0.05). Group A patients united radiologically in 4.63 ± 0.77 months (range; 3 months to 6 months), whereas Group B patients (except 2) took 5.59 ± 0.66 months (range; 4.5 months to 6 months) (p=0.007). Eventually, all the patients in group A resulted in radiological union and two patients in group B had nonunion. Clinically, the difference between mean Harris hip scores was significant statistically between two groups at 24 months (p=0.006). Conclusion iPRF may help femoral neck fractures heal in physiologically young individuals.