Abstract

➢ The failure rate of treatment of nonunions of the distal femur with internal fixation and autologous bone grafting remains high at 20% to 30%.➢ Successful treatment of nonunions of the distal femur requires good mechanical stability combined with autologous bone graft. This may require dual-plate fixation or intramedullary nail-plate combinations.➢ Autologous bone graft remains the bone graft of choice. Bone-graft substitutes and biologics require further research.

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