Treatment of aseptic diaphyseal nonunion of the lower extremities with exchange intramedullary nailing and blocking screws without open bone graft.
OBJECTIVE
To report the preliminary results of the treatment of aseptic diaphyseal nonunion of the lower extremities with exchange nailing plus blocking screws.


METHODS
Between June 2005 and September 2008, twelve patients with diaphyseal nonunion in the lower extremities (femur in five patients and tibia in seven; hypertrophic nonunion in eight patients and atrophic nonunion in four) were treated by reaming, exchanging the original intramedullary nail with a larger one, and using blocking screws, and the therapeutic effect assessed.


RESULTS
All patients were followed up for 1-2 years (average, 1.5 years) to assess union. Bony union was achieved in all patients within 4.7-13.5 months (average, 7.8 months). All patients were pain free without any complications by the last follow-up.


CONCLUSIONS
The therapeutic method of exchanging the nail combined with blocking screws is effective for aseptic nonunion of the lower extremity after intramedullary nailing.
Department of Orthopaedics, Shanghai First People's Hospital, Shanghai Jiaotong University, Shanghai, China.
Kan-da
KD
Gao
Jian-hua
JH
Huang
Fan
F
Li
Qiu-gen
QG
Wang
Hao-qing
HQ
Li
Jie
J
Tao
Jian-dong
JD
Wang
Xiao-ming
XM
Wu
Xiao-feng
XF
Wu
Zi-hui
ZH
Zhou
Fang
F
Wang
Hai-ming
HM
Lu
D000328:Adult; D001858:Bone Nails; D001863:Bone Screws; D016025:Bone Transplantation; D018483:Diaphyses / Q000293:injuries / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation*; D017102:Fracture Healing; D005599:Fractures, Ununited / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D011859:Radiography; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000601:surgery*