Treatment of femur aseptic non-unions after intramedullary nailing interfixation with locking plate

Abstract

Objective To investigate the therapeutic efficacy of locking plate with intramedullary nail rerserving fixation in the treatment of femoral nonunions after intramedullary fixation. Methods From January 2010 to January 2015, a total of 18 consecutive patients with femoral nonunions after intramedullary nailing interfixation were included. There were 8 females and 10 males with a mean age of (49±5) years (range 35-75 years), non-union time last for 6-34months, mean (17.6±2.3) months. All patients were treated with intramedullary reserving locking plate fixation combined with autogenous iliac grafting. The postoperative activity out of bed days, bone healing time, complications were evaluated. Results All patients were followed up for 6-20 months [average (12.0±1.4) months]. All patients achieved solid union [5-14 months, average (8.3±1.6) months]. Only one case suffered superficial surgical site infection. Postoperative VAS score was decreased from (6.0±1.3) preoperatively to (2.0±1.4), differences was statistically significant (t=7.312, P<0.05). so was the Johner-wruch score (χ2=28.000, P<0.05). Conclusion The locked plate combine with iliac bone grafting is a effective solution for femoral nonunion after intramedullary fixation, it can be applied for patients have femoral nonunion after intramedullary fixations. Key words: Femur; Fractures, ununited; Fracture fixation, internal; Internal fixators