DCP Fixation and Autogenous Bone Graft to Treat Nonunion of Femoral Shaft Fracture

Abstract

Background: Femoral shaft fracture is a relatively common injury of lower limbs, and surgery using close reduction with interlocking nail fixation usually produces good results with infrequent nonunion. However, some patients do develop fracture nonunion and need further surgical intervention to achieve union. The purpose of this report was to present the clinical results of dynamic compression plate (DCP) fixation with autogenous bone graft which was used to treat eight ununited femoral shaft fractures initially managed by intramedullary (IM) interlocking nailing. Methods: We treated eight cases of un united femoral shaft fracture with interlocking nail and later with dynamic compression plate fixation and autogenous bone graft supplementation at the China Medical College Hospital during the past 4 years. The clinical results were evaluated and a drilling technique with Kirschner wire (K-wire) for screw insertion was developed and is presented here. Results: Seven out of eight fractures united without complications. There was one case in which the nail broke after DCP fixation. Conclusions: Supplemental plate fixation promotes immediate mechanical stability, especially in terms of resisting torsion stress. Also, the cost of the implant and time consumed for this operation are comparable to other treatments of femoral nonunions. In summary, supplemental plate fixation is a practical and promising method with a good prognosis. Furthermore, the K-wire pre-drilled technique facilitates screw insertion and prevents intraoperative complications.