Platelet'den zengin plazma'nın (PRP) tavşanlarda oluşturulan kırık iyileşmesine etkilerinin araştırılması

Kırık kemik iyileşmesi 2 gruba ayrılabilir; internal remodelizasyon ile olan primer (direkt) iyileşme ve kallus oluşumu ile olan seconder (indirekt) iyileşme. Kemik iyileşmesi biyolojik olarak 3 evreden oluşur; Enflamasyon, Tamir evresi ve Remodelizasyon. Kırık iyileşmesini etkileyen olumsuz bircok etken olması, kırık iyileşmesi üzerine olumlu etki yapacak etken arayışına itmiştir. Plateletler (trombositler) kemik iliğinde yer alan beyaz kan hücrelerinden köken alan küçük hücre benzeri yapılardır. Plateletler; doku iyileşmesinde görev alan büyüme faktörleri ve sitokinlerce zengin olan alfa ve dens granülleri içeren en küçük kan hücreleridirler. PRP ise normal kan platelet (trombosit) konsantrasyonundan yaklaşık olarak 3-5 kez daha yogun platelet içerir. PRP, doku iyileşmesinde önem arzeden inflamasyon, proliferasyon ve remodelizasyon gibi bir çok hücresel aktiviteyi düzenler. Son yıllarda Platelet-rich plasma (PRP)’nın kırık iyileşmesine etkileri üzerine çalışmalar yapılmıştır. Bu çalışmada PRP nin tavşanlarda oluşturulan kırıklar üzerindeki etkilerinin araştırılması ve kontrol grubu ile karşılaştırılması amaçlanmıştır. Hazırlanan preperatlar sırasıyla; kortikal kallus oluşumu, kondroid alan yüzde oranı, örgü kemik alanı yüzde oranı, vasküler proliferasyon, osteoblastik aktivite, fibroblast proliferasyonu, matür kemik oluşumu açısından değerlendirildi. Curtis ve arkadaşlarının kullandığı evreleme yöntemi modifiye edilerek değerlendirildi. A grubu tavşanlarda kortikal kallus oluşumu B grubu tavşanlara oranla belirgin oranda düşük saptandı. A grubundaki tavşanlarda kondroid alanların yüzdeleri ile B grubundaki tavşanlarda kondroid alanların yüzdeleri benzer oranlarda bulundu. A grubu tavşanlara ait preperatlarda örgü kemik alanların yüzdeleri B grubu tavşanlara göre daha yüksek saptandı. B grubu tavşanlarda vasküler proliferasyon, A grubu tavşanlara göre daha yüksek saptandı. Osteoblastik aktivite her iki grupta da benzer oranlarda saptandı. Fibroblast’dan zengin alanların saptanması A grubunda daha kolay ve fibroblast sayısı daha fazla iken, B grubunda ise fibroblast’dan zengin alanların sayısı belirgin olarak daha az saptandı. A grubu tavşanlşarda matür kemik oluşumu büyük çoğunluğunda görülmezken, B grubu tavşanların ise tümünde matür kemik oluşumu tespit edildi. A grubu tavşanlara ait grafilerin 2’sinde kaynamama, diğerlerinde de zayıf kaynama bulguları saptanırken, B grubu tavşanların tümünde değişik oranlarda kaynama saptandı. Mann Whitney U testi ile, kortikal kallus oluşumu, örgü kemik alanı yüzdesi, fibroblast proliferasyonu bakımından iki grup ortancası arasındaki fark istatistiksel olarak anlamlı bulunmuştur (P<0,01). Kondroid alan yüzdesi ve osteoblast proliferasyonu bakımından iki grup ortancası arasındaki fark anlamlı bulunmamıştır (P=0,154, P=0,336). Vasküler proliferasyon bakımından T testi ile, iki grup ortalaması arasındaki fark istatistiksel olarak anlamlı bulunmuştur (P<0,01). Matür kemik oluşumu bakımından iki oran testi ile, anlamlı sonuç elde edebilmesi için gereken yeterli denek sayısı olmamasına rağmen iki grup arasındaki fark istatistiksel olarak anlamlı bulunmuştur (P<0,01). Radyolojik kaynama kriterlerine göre elde edilen veriler kaynama yüzdeleri bakımından istatistiksel olarak anlamlı bulunmuştur (P<0,05). Son yıllarda kırık iyileşmesini kötü etkileyen faktörlerinde artmasıyla kırıklar geç kaynamakta veya kaynamamaktadır. Yaptıgımız bu çalışma bize kırık hattına uygulanan PRP’nin kırık iyileşmesini hızlandırdığını ve kaynama şansını arttırdığını göstermektedir. Fracture healing can be divided into two groups; primary (direct) healing with internal remodeling and secondary (indirect) healing with callus. Fracture healing consists of three biological phases; Inflammation, Repair and Remodeling. Having many factors that have negative effect on fracture healing yield us to find the factors that have positive effects. Platelets are the small blood cells that include growth factors and cytokines, which are involved in the healing of the tissues that are rich with alpha and dense granules. PRP contains platelet concentration of approximately 3 to 5 times more than normal blood platelets (thrombocytes). PRP affects the inflammation, repair and remodeling phases of healing of the bone tissue. In recent years, studies have been conducted on the impact of Platelet-rich plasma (PRP) on fracture healing. This study investigates the effects of the PRP on the fractures in rabbits with comparison to the control group. Prepared samples were evaluated in terms of cortical callus formation, the percentage of chondroid, woven bone area percentage, vascular proliferation, osteoblastic activity, fibroblast proliferation and lamellar bone formation, in order. Staging technique of Curtis et. al. is evaluated with modification. Cortical callus formation in group-A rabbits is found significantly lower compared to the group-B rabbits. The percentage of chondroid tissues in group-A rabbits is found similar as in group-B rabbits. The woven bone area percentage of group-A rabbits is observed higher than the ones in group-B rabbits. Vascular proliferation is observed higher in group-B rabbits than in group-A rabbits. Osteoblastic activity is found at similar levels in both group-A and group-B rabbits. Fibroblast rich areas are observed more easily and fibroblast proliferation is significantly higher in group-A rabbits than in group-B rabbits. Mature bone formation is observed in all group-B rabbits while most of the group-A rabbits do not indicate any mature bone formation. Only two of radiographies belong to group-A rabbits present union while the rest of group-A radiographies show weak union indications. In all group-B rabbits, significant union is present at various levels. Mann-Whitney U test is applied. In terms of the cortical callus induction, the percentage of woven bone area, and fibroblast proliferation; the median difference between the two groups is found as statistically meaningful (P <0.01). The median difference between the two groups in terms of chondroid percentage and osteoblast proliferation is not significant (P = 0.154, P = 0.336). By T test for vascular proliferation, the difference between the two groups is statistically significant average (P <0.01). Although there is not enough number of subjects needed to achieve significant results with Ratio test, the difference between the two groups in terms of lamellar bone formation is statistically significant (P <0.01). The data obtained with respect to radiological union criteria is found statistically significant in terms of union percentages (P <0.05). In recent years, with the increase in factors that affect fracture healing, delayed union or non-union occurs often. This study shows that PRP applied to the fracture line accelerates the fracture healing process as well as it increases the chance of union

Kübital tünel sendromunda iki medial epikondilektomi tekniğinin karşılaştırılmas

Amaç: Bu çalışmada parsiyel medial epikondilektomi (PMe) ve distal medial epikondilektomi (DMe) teknikleri duyusal ve motor düzelme, fonksiyonel sonuçlar ve komplikasyonlar açısından karşılaştırıldı.Hastalar ve yöntemler: Çalışmaya toplam 59 kübital tünel sendromu hastası (37 erkek, 22 kadın, ort. yaş 42,3 yıl; dağılım 23-80 yıl) dahil edildi. Hastaların 30'una DMe, 29'una PMe uygulandı. Hastalar ameliyat öncesinde ve ameliyat sonrası üç, altı ve 12. aylarda Wilson Krout skorları, Semmes-Weinstein Monofilaman (SWM) testi ve kaba kavrama ve ince kavrama gücü ölçümleri ile değerlendirildi. Her iki grubun ameliyat öncesi ve sonrası grup içi ve gruplar arası sonuçları karşılaştırıldı.Bulgular: Ameliyat sonrası kontrollerde Wilson Krout skorları PMe'ye kıyasla DMe ile daha iyi idi. SWM testi skorlarındaki düzelme sadece DMe için istatistiksel olarak anlamlı idi. DMe grubunda kavrama, lateral ve terminal çimdikleme ölçümlerindeki düzelme ameliyat sonrası üçüncü ayda anlamlı idi. PMe grubunda bu ölçümler için anlamlı düzelme ameliyat sonrası altıncı ayda elde edildi. DMe ile görülen tek komplikasyon medial epikondil üzerinde ortaya çıkan hassasiyet idi. PMe grubunda dört hastada parestezinin eşlik ettiği ağrılı sinir subluksasyonu saptandı.Sonuç: PMe ile karşılaştırıldığında DMe daha tatmin edici sübjektif sonuçlar ortaya koymaktadır. DMe ile motor fonksiyonel iyileşme daha erken ortaya çıkmaktadır. DMe daha düşük komplikasyon oranlarına sahip görünmektedir.Objectives: This study aims to compare partial medial epicondylectomy (PMe) and distal medial epicondylectomy (DMe) techniques in terms of sensory and motor improvements, functional results and complications.Patients and methods: The study included a total of 59 cubital tunnel syndrome patients (37 males, 22 females; mean age 42.3 years; range 23 to 80 years). Of the patients, DMe was applied on 30 and PMe was applied on 29. Patients were evaluated with Wilson Krout scores, Semmes-Weinstein Monofilament (SWM) test, and grip and pinch strength measurements preoperatively and at postoperative third, sixth, and 12th months. Both groups' pre- and postoperative intragroup and intergroup results were compared.Results: Wilson Krout scores in postoperative checks were better with DMe compared to PMe. The improvement in SWM test scores was statistically significant for only DMe. The improvement in grip strength, lateral pinch and terminal pinch measurements in DMe group was significant at postoperative third month. In PMe group, significant improvement for these measurements was obtained at postoperative sixth month. The only complication observed with DMe was tenderness developing over the medial epicondyle. Painful subluxation of the nerve associated with paresthesia was detected in four patients in PMe group.Conclusion: Compared to PMe, DMe offers more satisfactory subjective results. Motor functional recovery occurs earlier with DMe. DMe appears to have lower complication rates

Comparison of Kinesiotaping, Exercise and Subacromial Injection Treatments on Functionality and Life Quality in Shoulder Impingement Syndrome: A Randomized Controlled Study

Canbeyli, Ibrahim Deniz/0000-0003-3880-4779; VERGILI, OZGE/0000-0002-5312-7684WOS:000539930100002Purpose Disturbance of scapulohumeral rhythm has been shown to play a major role in subacromial impingement syndrome. Exercise, taping and subacromial injection are first ray conservative treatment modalities. We aimed to correct scapulohumeral rhythm with kinesio taping and exercise program via focusing on especially periscapular muscles not on glenohumeral structures to achieve scapulothorasic stabilization. Material and Methods Seventy five patients were divided into three groups randomly with different treatment modalities which are only exercise group (Group 1), kinesiotaping + exercise group (Group 2), and injection + exercise group (Group 3). Western Ontario Rotator Cuff Index (WORCI), Quick Disability of arm, shoulder, hand (Q-DASH), Constant- Murley Scores (CMS) were evaluated for each patient at the beginning, 15th and 60th days and compared in time and technique manner. Scores were analyzed statistically with One-way ANOVA and Chi-square tests. Results All the three groups had better results in short and long term follow ups as compared to initial admission. But in the second group 15th and 60th day results were superior to other groups significantly (p < 0,001). Conclusions Most of recent studies using kinesio taping were focused on mechanical correction of humerus which will be an impaired treatment to correct the main cause of impingement. Not only mechanical correction of periscapular muscles and also stabilization of scapulae will help to gain scapulohumeral rhythm

The antibacterial effect of mesenchymal stem cells on graft infections: An experimental study

WOS: 000450917400008PubMed: 32082799Background: In this study, we aimed to investigate the antibacterial effects of mesenchymal stem cells, compared to tigecycline, on graft infection related with methicillin-resistant Staphylococcus epidermidis in a rat model. Methods: A total of 42 male adult Wistar rats (age >6 months; weight 300 to 350 g) were divided into six groups including seven rats in each. Group 0 did not undergo any procedure; Group 1 was infected, but untreated; Group 2 was infected and treated with tigecycline without graft placement; Group 3 was infected and received mesenchymal stem cells without graft placement; Group 4 was infected and treated with tigecycline after graft placement; Group 5 was infected and treated with mesenchymal stem cells after graft placement. The pockets created were either left empty or implanted with Dacron grafts. Treatment was commenced at 48 h. Specimens were collected on Day 13. Perigraft tissues were evaluated histopathologically and bacterial colony numbers were counted. Results: No bacterial colonization was observed in Group 0, whereas there was a significant colonization in Group 1. Complete eradication was achieved in Group 2 and Group 3 (graft-free groups), and near-complete eradication was achieved in Group 4 and Group 5 (graft-implanted groups). The histopathological findings significantly differed between Group 1-Group 2 and between Group 1-Group 3 (graft-free groups). The histopathological findings were similar between Group 2-Group 3 and between Group 4-Group 5. Conclusion: Our study results suggest that mesenchymal stem cells may be a novel, contemporary alternative to antibiotherapy and may decrease the bio-burden of Staphylococcus at the infected graft areas, and mesenchymal stem cell treatment may be as effective as tigecycline

Comparison of two medial epicondylectomy techniques in cubital tunnel syndrome

WOS: 000406744700003PubMed: 28760122Objectives: This study aims to compare partial medial epicondylectomy (PMe) and distal medial epicondylectomy (DMe) techniques in terms of sensory and motor improvements, functional results and complications. Patients and methods: The study included a total of 59 cubital tunnel syndrome patients (37 males, 22 females; mean age 42.3 years; range 23 to 80 years). Of the patients, DMe was applied on 30 and PMe was applied on 29. Patients were evaluated with Wilson Krout scores, Semmes-Weinstein Monofilament (SWM) test, and grip and pinch strength measurements preoperatively and at postoperative third, sixth, and 12th months. Both groups' pre- and postoperative intragroup and intergroup results were compared. Results: Wilson Krout scores in postoperative checks were better with DMe compared to PMe. The improvement in SWM test scores was statistically significant for only DMe. The improvement in grip strength, lateral pinch and terminal pinch measurements in DMe group was significant at postoperative third month. In PMe group, significant improvement for these measurements was obtained at postoperative sixth month. The only complication observed with DMe was tenderness developing over the medial epicondyle. Painful subluxation of the nerve associated with paresthesia was detected in four patients in PMe group. Conclusion: Compared to PMe, DMe offers more satisfactory subjective results. Motor functional recovery occurs earlier with DMe. DMe appears to have lower complication rates

Piknodisostozis: Uzun Kemik Kırıklarında Kanal İçi Çivilemenin Cerrahi Zorlukları: Vaka Sunumu

Pycnodysostosis, known as osteopetrosis acro-osteolytica, is a rare sclerotic bone disease with an autosomal recessive heritage pattern. Characteristic features of the disease are short stature, delayed closure of cranial sutures, partial or total dysplasia of the phalanges, obtuse mandibular angle, skeletal abnormalities and increased bone density. Type I collagen catabolism and bone resorption are defective in these patient due to lysosomal cysteine protease and cathepsin K enzyme defects resulting in dense and more brittle bones. Herein, we report a 45-year-old pycnodysostozis patient with a subtrochanteric transverse fracture of the left femur. We aim to reveal the difficulties encountered during intramedullary nailing of long bone fractures of patients with pycnodysostosis.Osteopetrosis akro-osteolotika olarak da bilinen piknodisostozis, otozomal resesif kalıtım özelliği gösteren, nadir görülen sklerotik bir kemik hastalığıdır. Hastalığın karakteristik özellikleri boy kısalığı, kraniyel sütürlerin geç kapanması, falanksların tam ya da kısmi displazisi, mandibula köşelerinin geniş açılı olması, iskelet anomalileri ve artmış kemik yoğunluğudur. Bu hastalarda, lizozomal sistein proteaz ve katepsin K enzim defektleri nedeniyle kırılgan kemik oluşumuna neden olan tip I kollajen katabolizması ve kemik rezorbsiyon defektleri mevcuttur. Bu makalede, sol subtrokanterik femur kırığı gelişmiş olan piknosiostozisli 45 yaşında bir hasta bildirilmektedir. Amacımız, piknodisostozis hastalarında uzun kemik kırıklarının kanal içi çivilenmesi sırasında karşılaşılan zorlukları gözden geçirmektir

Comparison of bench-top simulation versus traditional training models in diagnostic arthroscopic skills training

Canbeyli, Ibrahim Deniz/0000-0003-3880-4779WOS: 000449003900002PubMed: 30376796Objectives: This study aims to compare the efficacy of existing training models for acquisition of arthroscopic skills and to investigate the most effective training method or combination of methods for residents. Materials and methods: A total of 100 fifth-year students from medical school (40 males, 60 females; mean age 23.7 years; range, 22 to 33 years) volunteered to participate in the study and were randomly divided into five education groups (E1-5): group E1 (trained on bench-top simulator), group E2 (read surgical technique), group E3 (read surgical technique and watched surgical video), group E4 (watched surgical video only), and group E5 (control group). After completion of the pre-training, each student was individually asked to perform an arthroscopy practice. A checklist containing the tasks to be performed w as gig en to students and students were asked to complete the tasks on the checklist in five minutes. Results: In group E1, the mean rate of successful achievement of tasks was significantly higher than other groups in both knee and shoulder arthroscopy models. Rate of each task was statistically similar for groups E2, E3, E4 and E5. In group E1, mean durations for completion of tasks in both arthroscopy models were significantly shorter than other groups. There was no statistically significant difference in terms of gender between those who successfully completed the tasks in both arthroscopy models. Conclusion: A basic arthroscopic bench-top simulator may be a low-cost and effective training method to increase arthroscopic skill levels in resident training compared to traditional methods

Mesenchymal stem cells have significant anti-infective effect on methicillin-resistant Staphylococcus epidermidis vascular graft infections

WOS: 000495358300004PubMed: 31650915Objectives: This study aims to evaluate the effects of mesenchymal stem cell (MSC) implantation on vascular graft infections caused by methicillin-resistant Staphylococcus epidermidis (MRSE) and compare with antibiotic treatment. Materials and methods: Healthy adult 56 Wistar rats (age, over 5 months: weighing. 300-350 g) were divided into eight groups. Group I was defined as the control group and group 2 was defined as the infected control group. Groups 3 and 4 were defined as Dacron grafted and MRSE infected groups. treated with tigecycline and MSCs. respectively. Groups 5 and 6 were performed polytetrafluoroethylene (PTFE) graft and infected with MRSE. These groups were also administered tigecycline and MSC treatment. respectively. Groups 7 and 8 were infected with MRSE without graft administration and were also performed tigecycline and MSC treatment. respectively. Grafts and soft tissue specimens were collected at 13 days postoperatively. Colony counts of pert-graft tissue were performed. All samples were evaluated by enzyme-linked immunosorbent assay (ELISA) for the markers that determine stem cell activity. Results: The overall success of the treatments was assessed by the number of rats with MRSE recurrence, regardless of graft used. The difference between the untreated group 2, tigecycline groups (3. 5 and 7) and MSCs groups (4.6 and 8) were statistically significant. Success of MSC and tigecycline treatments was similar in Dacron. PTFE, and non-grafted groups. There was a resistance of MRSE infection in Dacron groups to MSC and tigecycline treatments. This was considered to be indicative of the susceptibility of the Dacron grafts to infection. However, there was no significant difference between group 2 and Dacron groups in terms of bacterial colonization. ELISA results were significant in three cytokines. Conclusion: Mesenchymal stem cells can be considered as an alternative treatment option on its own or part of a combination therapy for control of vascular graft infections.Kirikkale University Scientific Research CouncilKirikkale UniversityThis study was supported by Kirikkale University Scientific Research Council

A1 ve A2 tipi femur intertrokanterik kırıklarında kayan kalça vidası ve proksimal femur çivisi-antirotasyon ile tespit sonrası hastaların fonksiyonel sonuçlarının karşılaştırılması

BACKGROUND: We aimed to compare clinical and functional outcomes between patients treated with Dynamic hip screw (DHS) and Proximal Femoral Nail-Antirotation (PFN-A) implants. METHODS: This study included 122 patients (66 men [54.1%] and 56 women [45.9%]) who underwent surgery with DHS and PFN-A for an intertrochanteric femur fracture and had at least 12 months follow-up. Reduction assessment, femoral neck-shaft angle and tip-apex distance measurements were performed in early postoperative radiographs. On control visits in months 1, 3, 6 and 12, range of motion, thigh or hip pain, and Trendelenburg positivity were assessed in clinical examination and reduction assessment, femoral neck-shaft angle and tip-apex distance measurements were performed on radiographs after the union. Patients were assessed using Hip Harris Score after the union. RESULTS: Regardless of implant type used, mean tip-apex distance measured at the immediate postoperative period was 27.6 in patients with implant failure, whereas 21.6 in patients without, indicating a significant difference. Again, mean femoral neck-shaft angle measured at the immediate postoperative period was 123 degree in patients with implant failure, whereas 130 degree in those without, indicating a significant difference. It was found that the femoral neck-shaft angle was 128 degree in 94% of patients without implant failure at immediate postoperative period. CONCLUSION: The findings regarding femur neck-shaft angle at the immediate postoperative period was <128 degree in all patients with implant failure and that it was ?128 degree in 94% of patients without implant failure emphasize the importance of anatomic restoration in femur neck-shaft angle during surgery. The finding that mean tip-apex distance was 27.6 mm in patients with implant failure and 21.6 mm in patients without implant failure indicates that the technique is as important as implant type selected for treatment success of the implantation.AMAÇ: Dinamik hip screw (DHS) ve proksimal femoral çivi-antirotasyonu (PFN-A) implantları ile tedavi edilen hastaların klinik ve fonksiyonel sonuçlarını karşılaştırmayı amaçladık. GEREÇ VE YÖNTEM: Çalışmaya Kırıkkale Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalı’nda femur intertrokanterik kırığı nedeniyle DHS ve PFN-A kullanılarak ameliyat edilen, en az 12 ay takibi olan 66’sı erkek, 56’sı kadın olan toplam 122 hasta alındı. Hastaların erken postoperatif grafilerinde kırığın redüksiyonu değerlendirilmesi, boyun cisim açısı ve tip apeks mesafesi ölçümleri yapıldı. Postoperatif 1. ay, 3. ay, 6. ay, 12. ay yapılan takiplerinde kalça eklem hareket açıklığı, uyluk-kalça ağrısı, Trendelenburg pozitifliği bakıldı ve takiplerdeki ve kaynama sonrası çekilen grafilerinde redüksiyon, fiksasyon kaybı, boyun cisim açısı ve tip apeks mesafesi ölçümleri yapıldı. Hastalar kaynama sonrası dönemde Kalça Harris Skoru ile değerlendirildi. BULGULAR: Kullanılan implanttan bağımsız olarak implant yetmezliği görülen grupta erken postoperatif ölçülen tip apeks mesafesi ortalaması 27.6 iken implant yetmezliği görülmeyen grupta 21,6 idi ve istatistiksel olarak anlamlı bir fark saptandı. Kullanılan implanttan bağımsız olarak implant yetersizliği görülen grupta erken postoperatif ölçülen boyun cisim açısı ortalaması 123 iken implant yetersizliği görülmeyen grupta 130 idi ve istatistiksel olarak anlamlı bir fark saptandı. İmplant yetersizliği görülen hastaların tümünde erken postoperatif ölçülen boyun cisim açısının 128 derecenin altında olduğu saptandı. İmplant yetersizliği görülmeyen hastaların %94’ünün erken postoperatif ölçülen boyun cisim açısının 128 derecenin üstünde olduğu saptandı. TARTIŞMA: İmplant yetersizliği olan hastaların tümünde erken postoperatif boyun cisim açısının 128° altında olması ve implant yetersizliği görülmeyen hastaların %94’ünde erken postoperatif boyun cisim açısının 128° ve üzerinde olması cerrahi sırasında bu açının anatomik şekilde restore edilmesinin önemini ortaya çıkarmaktadır. İmplant yetersizliği görülen grupta TAD’nin ortalama 27.5 mm ve implant yetersizliği görülmeyen grupta ortalama 21.7 olması, bu sistemlerin implantasyonunda tedavi başarısı açısından tekniğin en az seçilen implant türü kadar önemli olduğunu göstermektedir

Platelet-rich plasma decreases fibroblastic activity and woven bone formation with no significant immunohistochemical effect on long-bone healing: An experimental animal study with radiological outcomes

Purpose: This study aimed to analyze the immunohistochemical effect of platelet-rich plasma (PRP) on healing of long-bone fractures in terms of bone morphogenetic protein-2 (BMP-2), vascular endothelial growth factor (VEGF), the Ki-67 proliferation index, and radiological and histological analyses. Methods: Sixteen adult rabbits, whose right femoral diaphysis was fractured and fixed with Kirschner wires, were randomly divided into two groups, control and PRP (groups A and B, respectively). PRP was given to group B at 1 week postoperatively, and all animals were euthanized after 12 weeks. Radiographic evaluations were performed periodically. Cortical callus formation, chondroid and woven bone area percentages, osteoblastic and fibroblastic activities, and mature bone formation were examined. The depths of BMP-2 and VEGF staining were measured. The Ki-67 proliferation index was also calculated. Results: The mean radiological union score of group B was significantly higher than that of group A. There were also statistically significant differences between groups A and B in terms of cortical callus formation, woven bone area percentage, fibroblast proliferation, and mature bone formation. Group B had significantly more cortical callus and mature bone formation with less woven bone and fibroblast proliferation. Immunohistochemical analysis revealed no statistically significant difference between the groups in terms of BMP-2 and VEGF staining and the Ki-67 index. Conclusions: PRP had no effect on BMP-2 or VEGF levels with no increase in the Ki-67 proliferation index, although its application had a positive effect on bone healing by increasing callus and mature bone formation with decreased woven bone and fibroblast proliferation