Plate Augmentation with Retention of Intramedullary Nail is Effective for Resistant Femoral Shaft Non-union

Overview

Journal J Orthop

Specialty Orthopedics

Date 2016 Jul 14

PMID 27408496

Citations 16

Authors

Raju Vaishya

Amit Kumar Agarwal

Nishint Gupta

Vipul Vijay

Affiliations

Soon will be listed here.

Abstract

Objective: Non-union after intramedullary nail fixation of femur shaft fractures is although infrequent but a challenging condition to treat. The treatment options available to deal with such a situation include exchange nailing, removal of nail and re-osteosynthesis with plating, or Ilizarov fixation. We believe that rotational instability, in the presence of a nail, is one of the main reasons for most of the non-union. We present our experience of plate augmentation leaving the nail in situ for non-union of femoral shaft fracture.

Methods: In this retrospective study, we had operated 16 cases of the femoral shaft non-union, which were treated by plate augmentation and bone grafting (if needed) with retention of the intramedullary interlocking nail in situ. The cases of infected non-union and any fracture less than one-year duration were excluded from the study.

Results: Bone grafting was done only in 4 cases with atrophic non-union. We could achieve union in all the cases at an average time of 6.25 months. The average time of surgery between the primary surgery of interlocking nail fixation and the plate augmentation was 13 months. Mean surgical time for plate augmentation and bone grafting was 71 min. No major complication or implant failure was encountered. An average residual shortening of the limb was 0.9 cm and average range of motion of the knee was 115°.

Conclusion: Plate augmentation seems an effective, reliable, safe and an easy procedure for the treatment of femoral shaft non-union after an intramedullary nailing.

Citing Articles

Comparative Study of Exchange Nailing and Augmentative Plating for Treating Aseptic Nonunion of Femoral Shafts Post Intramedullary Nailing: A Single-Blind, Multicentric Randomized Clinical Trial.

Motififard M, Mousavi H, Iranpanah N, Akbari Aghdam H, Teimouri M, Aliakbari M J Clin Med. 2024; 13(22).

PMID: 39598072 PMC: 11594341. DOI: 10.3390/jcm13226928.

Management of infected bone defects of the femoral shaft by Masquelet technique: sequential internal fixation and nail with plate augmentation.

Yang X, Xu X, Li J, Song M, Sun H, Zhang H BMC Musculoskelet Disord. 2024; 25(1):552.

PMID: 39014409 PMC: 11253414. DOI: 10.1186/s12891-024-07681-x.

Plate augmentation and hybrid bone grafting are effective treatments for atrophic nonunion of the femur with the original intramedullary nail retained in situ.

Qiang H, Congming Z, Teng M, Kun Z, Chaofeng W Sci Rep. 2024; 14(1):7089.

PMID: 38528078 PMC: 10963732. DOI: 10.1038/s41598-024-57809-1.

Comparing outcomes of plate augmentation, nail exchange, and nail exchange with plate augmentation in the treatment of atrophic femoral shaft nonunion after intramedullary nailing: a multicenter retrospective study.

Kook I, Oh C, Shon O, Kim J, Kim J, Hwang K Arch Orthop Trauma Surg. 2024; 144(3):1259-1268.

PMID: 38372763 DOI: 10.1007/s00402-023-05183-4.

Fixators dynamization for delayed union and non-union of femur and tibial fractures: a review of techniques, timing and influence factors.

Hu M, Zeng W, Zhang J, Feng Y, Ma L, Huang F J Orthop Surg Res. 2023; 18(1):577.

PMID: 37550732 PMC: 10405409. DOI: 10.1186/s13018-023-04054-3.

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