[Augmentative plate fixation for the treatment of femoral hypertrophic nonunions subsequent to intramedullary nailing fixation].
OBJECTIVE
To investigate the effect of augmentative plate fixation to increase stability in the treatment of femoral shaft nonunions subsequent to intramedullary fixation.


METHODS
Nine patients with femoral nonunions after intramedullary nail internal fixation were treated with augmentative plate internal fixation from April 1998 to Jane 2008, included 8 males and 1 female, with an average age of 32 years old ranging from 21 to 54 years. One case was upper 1/3 femoral fractures, 5 cases were middle 1/3 femoral fractures, 3 cases were lower 1/3 femoral fractures. The interspace of bone nonunion was more than 5 mm in 6 cases, of them, iliac bone grafting were applied in 4 cases, artificial bone combined with iliac bone grafting were applied in 2 cases; The interspace of bone nonunion was less than 5 mm in other 3 cases,artificial bone grafting was applied in 1 case, fitting bone callus were applied in 2 cases. All patients got protected weight loading preventing the main screw break.


RESULTS
All patients achieved radiological solid union at an average of 8 months (ranged 6 to 11 months ). The fixation was removed during 6 to 11 months after operation in 5 cases. Donor site pain of iliac occurrenced on 4 cases,3 cases relieved 1 month later and 1 case relieved 3 months later. No infection, fixation loosening or breaking was observed.


CONCLUSIONS
The augmentative plate fixation can be applied at the fracture site to prevent the rotational instability. The technique is simple and does not require any special instrument, which facilitates an early weight bearing and gives a quick recovery from nonunion.
Department of Orthopaedics, General Hospital of Beijing Military Command, China.
Jian-Zheng
JZ
Zhang
Zhi
Z
Liu
Tian-Sheng
TS
Sun
Jing-Sheng
JS
Li
Ji-Xin
JX
Ren
Shu-Qing
SQ
Liu
Shao-Ting
ST
Xu
D000328:Adult; D001860:Bone Plates; D005260:Female; D005264:Femoral Fractures / Q000601:surgery*; D005269:Femur / Q000473:pathology*; D005594:Fracture Fixation, Intramedullary / Q000379:methods*; D005599:Fractures, Ununited / Q000601:surgery*; D006801:Humans; D006984:Hypertrophy; D008297:Male; D008875:Middle Aged