Intramedullary compression interlocking nail in treatment of non-union and delayed union of femoral and tibial fractures

Abstract

Objective To investigate the cause of non-union and delayed union of femoral and tibia] fractures and assess the clinical outcome after treatment with intramedullary compression interlocking nail (ICIN). Methods From February 1998 to December 2006, 21 patients with non-union and delayed union of femoral and tibial fractures (13 patients with femoral fractures and 8 with tibial fractures) were treated by ICIN. Bone grafting was performed in 18 patients, and the other three patients only rocoived reamed compression nailing. Five patients received bone grafting combined with knee adhesion release operation. Results All patients were followed up for 11.4-36 months (mean 13.6 months). Solid bone union was observed in all patients, with mean bone union time of 8.7 months and without malunion, infection or refracture. According to the Klemm grading, the clinical outcome was graded excellent in 19 patients and good in 2. Conclusions The main causes for non-union and delayed union of femoral and tibial fractures are improper indication selection and incorrect use of implants, which may result in bieenvironment disruption. ICIN shortens the time of functional recovery of knee and ankle joint. ICIN has advantages of stable fixation, early exercise of the knee and ankle as well as early weight loading and hence is one of effective alternatives in treatment of non-union and delayed union of femoral and tibial fractures. ICIN can accelerate the healing of bone and improves the function of knee joint when combined with bone grafting, reamed compression nailing and knee adhesion release. Key words: Femoral fractures; Tibial fractures; Fracture fixation, intramedullary; Frachues, nonunion