Abstract:

BACKGROUND: Interlocking intramedullary nail is the prior choice for femoral fractures. Previous studies have shown that treatments for nonunion of femoral fractures following intramedullary nail concentrate on replace nails or changed to plate fixation, which is unacceptable for patients due to great trauma and high cost.
OBJECTIVE: To explore the effect of plate combined with bone graft on the postoperative femoral fractures nonunion treated by interlocking intramedullary nail.
METHODS: Twenty cases of postoperative femoral fracture nonunion treated by interlocking intramedullary nail from February 2006 to December 2008 were entered in our surgery. They received operations to remove the fibrous tissue and sclerosis bone. Then anterolateral or posterolateral of femoral was fixed by 7-9-well forearm plates, and the fracture ends were fixed using 3 nails. After fixation, the autogenous iliac bone was grafted at fracture end. After treatment, patients receive functional exercise without weight-bearing or with weight-bearing, which turned to full weight-bearing when the fracture was united. 
RESULTS AND CONCLUSION: All 20 cases were available for follow up. The follow-up lasted for 8-12 months. All cases achieved solid union within 3-10 months, averaged 5 months. There was no disorder of limb’s activity. Plate combined with bone graft is characterized by simple operation, reliable effect and early motion, which is an ideal method for treatment of postoperative femoral fractures nonunion treated by interlocking intramedullary nail.