Augmentation plating in hypertrophic non-union after nail fixation of femoral shaft fracture compared with exchange plating

Abstract

Background Augmentation plating has been used successfully to treat hypertrophic non-union after nail fixation. This study compared the efficacy of augmentation plating and exchange plating for treating hypertrophic non-union of femoral shaft fracture after intramedullary nail fixation. Methods A total of 12 patients received augmentation plating and 15 patients received exchange plating as treatment for femoral shaft hypertrophic non-union. The procedures were conducted at our medical centre between January 2005 and January 2012. Clinical follow-up was conducted at 2 weeks, 1 month and then monthly until union was achieved to compare union time, operation time, bleeding and complications between the two groups. Results All patients underwent follow-up examinations until fracture union was achieved. The average length of followup time after the second treatment was (18.37±3.28) months. The time needed for union was (4.17±0.94) months in the augmentation plating group and (5.33±1.72) months in the exchange plating group. The operation time was (90.00±17.58) minutes in the augmentation plating group and (160.00±25.35) minutes in the exchange plating group. The amount of blood loss during the operation was (270.00±43.32) ml in the augmentation plating group and (530.00±103.65) ml in the exchange plating group. Both groups showed significant difference (P <0.05) in their results. No complications were reported after the second operation. Conclusions Augmentation plating after nail fixation could remove local rotation instability, facilitate simple operation, create minimal damage and enable exercise for early functional recovery. Therefore, augmentation plating is excellent for treating hypertrophic non-union after nail fixation in femoral shaft fracture.