title: Plate augmentation for femoral nonunion: more than just a salvage tool?
abstract: OBJECTIVE
  The aim of the current study was to determine whether plate augmentation was a successful treatment algorithm for selected femoral nonunions initially managed with intramedullary nailing.
  
  
  METHODS
  A total of 30 femoral nonunion cases were managed using the plate augmentation strategy with 13 primary cases and 17 multi-operated femurs (avg 2.8 ineffective procedures). Adjunctive strategies included autologous bone grafting and/or BMP for atrophic/oligotrophic and bone defect cases. Deformity correction was performed when required.
  
  
  RESULTS
  Osseous union occurred in 29 of 30 cases. One multi-operated case with bone defect and prior infection required repeat autologous grafting prior to union.
  
  
  CONCLUSIONS
  Plate augmentation should be added to the armamentarium for management of selected femoral nonunion that have failed initial intramedullary nailing.
authors.affiliation: Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors.forename: J C
authors.initials: JC
authors.lastname: Chiang
authors.affiliation: Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors.forename: J E
authors.initials: JE
authors.lastname: Johnson
authors.affiliation: Department of Orthopaedic Surgery, Division of Orthopaedic Trauma, University of Pittsburgh Medical Center, Kaufmann Building, Suite 911, 3471 Fifth Avenue, Pittsburgh, PA, 15213, USA. tarkinis@upmc.edu.
authors.forename: I S
authors.initials: IS
authors.lastname: Tarkin
authors.affiliation: Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors.forename: P A
authors.initials: PA
authors.lastname: Siska
authors.affiliation: Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors.forename: D J
authors.initials: DJ
authors.lastname: Farrell
authors.affiliation: Department of Orthopaedic Surgery and Rehabilitation, Nebraska Medical Center, Omaha, NE, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Mormino
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D064592:Autografts; D019485:Bone Morphogenetic Proteins; D001860:Bone Plates; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D005594:Fracture Fixation, Intramedullary; D017102:Fracture Healing; D005599:Fractures, Ununited / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007085:Ilium / Q000637:transplantation; D008297:Male; D008875:Middle Aged; D011859:Radiography; D016879:Salvage Therapy
chemical_list: D019485:Bone Morphogenetic Proteins
keywords: Bone graft; Exchange nail; Femur nonunion; Intramedullary nail; Plate augmentation