[The surgical technique and follow-up of the treatment with locking internal fixation on long bone nonunion of extremities].
OBJECTIVE
To report the outcome of long bone nonunion of humerus, femur and tibia treated with locking internal fixation and bone graft.


METHODS
From February 2003 to October 2006, locking internal fixation and bone grafting were employed to treat 5 cases at humerus, 33 cases at femur, 23 cases at tibia. Forty-four of the patients were men, and 17 were women. The mean age was 38 years (range 7-70 years). The nonunion had resulted from failure of internal fixation in 47 cases, failure of external fixation in 5 cases, infection in 9 cases. The history of nonunion lasted from 10 to 156 months (mean 19 months). There were 42 patients treated with locking compression plate (LCP), and 19 patients with less invasive stabilization system (LISS). For bone grafting, autogenous ilium was used in 55 patients, autogenous ilium and allograft bone was used in 3 patients, allograft bone and Wright DBM artificial bone was used in 3 patients.


RESULTS
All the 61 patients were followed up for an average 12 months (range 6-24 months) only to reveal solid bone union in all the fracture, with a mean healing time of 4.8 months (ranged from 4 to 6 months). No loosening or breakage of the implants occurred in this series. The Knee Society Scores (KSS) was used to evaluate knee function in 47 patients with peri-knee joint nonunion, excellent result were seen in 35 patients, good in 7 patients, fare in 1 patients, poor in 4 patients.


CONCLUSIONS
Locking internal fixation can be used to treat effectively bone nonunion at the humerus, femur and tibia.
Zhang
Chang-Qing
CQ
Department of Orthopaedics, Shanghai Sixth People's Hospital, Jiaotong University, Shanghai 200233, China.
Cheng
Xiang-Guo
XG
Sheng
Jia-Gen
JG
Li
Hong-Shuai
HS
Su
Yan
Y
Xu
Jun
J
Zeng
Bing-Fang
BF
D000293:Adolescent; D000328:Adult; D000368:Aged; D001860:Bone Plates; D002648:Child; D005260:Female; D005264:Femoral Fractures / Q000601:surgery; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D005599:Fractures, Ununited / Q000601:surgery*; D006801:Humans; D006810:Humeral Fractures / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013978:Tibial Fractures / Q000601:surgery; D016896:Treatment Outcome