title: Management of nonunion associated with broken intramedullary nail of the femur.
abstract: This study analyzed 14 patients with 17 broken intramedullary nails for the treatment of femoral fractures. Average distance from the fracture site was 7.9 cm in cases in which nail breakage occurred at the junction between the cylindrical and cloverleaf portions and 6.4 cm in cases in which nail breakage occurred at the screw hole. Eleven patients with 14 broken nails were treated with exchange nailing and bone grafting, 2 were treated with plating and bone grafting, and 1 was treated with extracorporeal shock wave therapy. Nonunion or delayed union is the main cause of nail breakage. Exchange nailing with bone grafting is a safe and effective method of treatment for a broken intramedullary nail with nonunion.
authors.affiliation: Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung, Taiwan, Republic of China.
authors.forename: Chin-En
authors.initials: CE
authors.lastname: Chen
authors.forename: Lin-Hsiu
authors.initials: LH
authors.lastname: Weng
authors.forename: Jih-Yang
authors.initials: JY
authors.lastname: Ko
authors.forename: Ching-Jen
authors.initials: CJ
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D001858:Bone Nails / Q000009:adverse effects*; D020878:Device Removal; D005260:Female; D005264:Femoral Fractures / Q000209:etiology* / Q000601:surgery*; D005594:Fracture Fixation, Intramedullary / Q000009:adverse effects* / Q000295:instrumentation*; D017759:Fractures, Malunited / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D012086:Reoperation; D016896:Treatment Outcome; D055815:Young Adult