title: Plate augmentation and autologous bone grafting after intramedullary nailing for challenging femoral bone defects: a technical note.
abstract: The treatment of a large segmental defect of over 6 cm in a long bone is a challenging procedure. Treatment options include cancellous bone graft (e.g., the Masquelet technique), vascularized fibular graft (VFG), and internal bone transport (IBT) with an external fixator. These methods may be performed with intramedullary (IM) nailing or plate fixation to enhance stability or to lessen the time of external fixation. Each method has its own advantages and limitations. This study aimed to describe the advantages of additional plate augmentation and autologous bone grafting after IM nail implantation. Three patients with large segmental femoral bone defects were treated with IM nail implantation; then, one- or two-stage autologous iliac bone grafting with additional plate augmentation was performed. All patients achieved bony union without metal failure. We describe a technique involving additional plate augmentation and autologous iliac bone grafting for treating large femoral defects after restoring the length of the femur using an IM nail implantation and an external fixator.
authors.affiliation: Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Kyu-Hyun
authors.initials: KH
authors.lastname: Yang
authors.affiliation: Department of Orthopaedic Surgery, Konyang University College of Medicine, Daejeon, Korea. yougunwon@gmail.com.|Department of Orthopaedics, Graduate School of Medicine, Yonsei University, Seoul, Korea. yougunwon@gmail.com.
authors.forename: Yougun
authors.identifier: http://orcid.org/0000-0002-0874-5248
authors.initials: Y
authors.lastname: Won
authors.affiliation: Department of Orthopaedic Surgery, Konyang University College of Medicine, Daejeon, Korea.
authors.forename: Sang Bum
authors.initials: SB
authors.lastname: Kim
authors.affiliation: Department of Orthopaedic Surgery, Konyang University College of Medicine, Daejeon, Korea.
authors.forename: Byung-Hak
authors.initials: BH
authors.lastname: Oh
authors.affiliation: Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Young Chang
authors.initials: YC
authors.lastname: Park
authors.affiliation: Department of Orthopaedic Surgery, Konyang University College of Medicine, Daejeon, Korea.
authors.forename: Sang Jin
authors.initials: SJ
authors.lastname: Jeong
mesh_terms: D000328:Adult; D001860:Bone Plates; D016025:Bone Transplantation / Q000379:methods*; D005264:Femoral Fractures / Q000601:surgery*; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D007085:Ilium / Q000637:transplantation*; D008297:Male; D008875:Middle Aged; D014182:Transplantation, Autologous
keywords: Bone defect; Intramedullary nailing; Plate augmentation