title: Open interlocked nailing without a targeting device or X-ray guidance for non-union of the femur: a case series.
abstract: From October 2005 to August 2007, we operated on six patients who had femoral non-unions and performed interlocked intramedullary nailing without X-ray guidance or a targeting device. There were three fractures of the distal femur, two fractures of the mid-shaft and one of the proximal femur. Fatigue failure of a non-interlocked Kuntscher nail and one nail migration were the presenting features in two patients. The presence of sclerosis of the bone ends in four cases and a need for cancellous bone grafts at the site of non-union in all patients made wide dissection and open reduction unavoidable. There was a limb length discrepancy in all patients before surgical intervention. Partial weight bearing was commenced at 6 weeks post-operation. There was no case of wound infection. There was no misplaced screw. Minimum range of knee flexion was 105° at 2 months post-operation. These early results call for a closer look at this cheap, safe and effective means of handling femoral non-union in third world societies where there is paucity of instrumentation and implants for interlocked nailing.
authors.affiliation: Department of Orthopaedics and Trauma, University of Benin Teaching Hospital, Benin City, Edo State Nigeria.
authors.forename: Alfred O
authors.initials: AO
authors.lastname: Ogbemudia
authors.forename: Anire
authors.initials: A
authors.lastname: Bafor
authors.forename: Efosa
authors.initials: E
authors.lastname: Igbinovia
authors.forename: Peter E
authors.initials: PE
authors.lastname: Ogbemudia