Resistant Distal Femoral Nonunion Treated with Combined Nail/plate Construct and Reamer-irrigator-aspirator Technique

Overview

Journal J Int Med Res

Publisher Sage Publications

Specialty General Medicine

Date 2023 Jul 27

PMID 37498625

Authors

Jin-Hui Zhang

Hui Liu

Tao-Yi Cai

Yong-Zhi Lin

Jin Wu

Affiliations

Soon will be listed here.

Abstract

Objective: This study was performed to evaluate the effectiveness of intramedullary nailing and a lateral locking plate combined with the reamer-irrigator-aspirator (RIA) bone grafting technique for resistant distal femoral nonunion.

Methods: This retrospective observational study was performed from January 2018 to December 2021 and involved five patients who presented with resistant distal femoral nonunion despite undergoing several surgeries. They were treated with intramedullary nailing and a lateral locking plate combined with the RIA bone grafting technique. Postoperative follow-up was performed to observe the healing time, and functional outcomes were evaluated using the Lower Extremity Functional Scale (LEFS).

Results: After the patients had been monitored for a mean of 17.9 months, complete bone healing was observed in every patient (mean healing time of 4.8 months). Postoperative wound failure in an older patient was successfully treated with resuturing and nutritional assistance. At the last follow-up, the mean LEFS score was 71.2/80 and the mean knee flexion was 109 degrees.

Conclusions: Our study demonstrates that combining intramedullary nailing and a lateral locking plate with the RIA bone grafting technique enhances biological properties, provides good structural support, and achieves good union and functional results in the management of resistant nonunion of the distal femur.

Citing Articles

Management of Distal Femoral Non-union: A Systematic Review.

Migliorini F, Schafer L, Simeone F, Vaish A, Bhadani J, Vaishya R Indian J Orthop. 2024; 58(12):1686-1723.

PMID: 39664354 PMC: 11628467. DOI: 10.1007/s43465-024-01205-4.

Best of Both Worlds? Fixation of Distal Femur Fractures with the Nail-Plate Construct.

Pfister B, Wilson A, Drobetz H Orthop Surg. 2023; 15(12):3326-3334.

PMID: 37866825 PMC: 10694005. DOI: 10.1111/os.13927.

Application of femoral nail, reconstruction locked plate and bone morphogenic protein - 7 in an osteopetrosis patient with a recurrent femoral shaft fracture: A case report.

Liu H, Zhang J, Luo D, Cai T, Lin Y, Wu J Int J Surg Case Rep. 2023; 109:108628.

PMID: 37562280 PMC: 10424210. DOI: 10.1016/j.ijscr.2023.108628.

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