Management of nonunion of diaphyseal femoral fractures using exchange nailing versus plate augmentation

Abstract

ObjectivesThe aim of this study was to compare the clinical and radiographic outcomes of exchange nailing versus plate augmentation for the management of patients with nonunion of diaphyseal femoral fractures.BackgroundDue to its superior biomechanical and biological properties, intramedullary nailing of the femur has enjoyed widespread acceptance in the management of femoral diaphyseal fractures. However, nonunion occasionally occurs secondary to malreduction, inaccurate implant placement, and unfavorable fracture pattern.Patients and methodsThis was an interventional prospective cohort study to evaluate the treatment options, which was conducted at the Department of Orthopedics and Traumatology, Menoufia University Hospital between May 2017 and July 2019.ResultsThere was no significant difference between the studied groups as regards postoperative blood loss, P value of 0.183. There was no significant difference as regards preoperative versus postoperative range of motion, P value of 0.561.ConclusionDiaphyseal femoral fracture nonunion can be successfully treated by either exchange nailing and bone grafting or by augmentation plating and bone grafting; however, the later has less operative time and lower reoperation rate.