Management of femoral diaphyseal nonunion after nailing with augmentative locked plating and bone graft.
OBJECTIVE
Exchange nailing (EN) for aseptic femoral shaft nonunion is currently a standard orthopaedic treatment modality. However, according to recent studies there is occasionally a high failure rate when EN is used. In the present study, augmentative locked plating and bone graft was used as an alternative method for treating such cases. The purpose of this study was to report the treatment outcomes of selected femoral diaphyseal nonunions that had initially been treated by nailing.


METHODS
Thirteen patients with femoral diaphyseal nonunions underwent revision surgery with locked plate and bone graft. The inclusion criteria were: (a) nonisthmic nonunion; (b) atrophic/oligotrophic nonunion. All patients were managed by augmentative locked plating and bone graft.


RESULTS
All patients were followed up for a mean of 1.2 years (range, 1-2 years). After revision surgery all nonunions achieved bony union, the average union time being 7.5 months (range, 6-12 months). No major complications were observed in this case series.


CONCLUSIONS
Augmentative locked plating is an effective and simple technique for treatment of femoral diaphyseal nonunion after nailing in selected cases.
Department of Orthopaedics, Shanghai First People's Hospital, Shanghai Jiaotong University, Shanghai, China. gaokanda@sina.com.cn
Kan-da
KD
Gao
Jian-hua
JH
Huang
Jie
J
Tao
Fan
F
Li
Wei
W
Gao
Hao-qing
HQ
Li
Qiu-gen
QG
Wang
D000328:Adult; D001860:Bone Plates; D016025:Bone Transplantation; D018483:Diaphyses / Q000293:injuries / Q000601:surgery; D005260:Female; D005264:Femoral Fractures / Q000601:surgery*; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D005599:Fractures, Ununited / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome