Augmentation plating with bone grafting for nonunions of femoral shaft fractures after intramedullary nail fixation

doi:10.3969/j.issn.2095-4344.2013.04.007

Abstract

Abstract:

BACKGROUND: For the patients with nonunions of femoral shaft comminuted fractures, non-isthmus and bone defects after treated with intramedullary nail fixation, the clinical efficacy of replacing the intramedullary nail is not satisfactory.
OBJECTIVE: To observe the therapeutic effect of augmentation plating with bone grafting for aseptic nonunions of femoral shaft fractures after intramedullary nail fixation through a retrospective analysis of 18 cases.
METHOIDS: All the 18 cases with aseptic nonunions of femoral shaft fractures after intramedullary nail fixation were selected from Jiangsu Provincial Corps Hospital of the Chinese People’s Armed Police Force from April 2001 to June 2011. All patients retained the original intramedullary nail, augmentation plating of 6 to 11 holes dynamic compression plate or locking compression plate, wrenching 2 to 4 screws (locking or common, single or double cortex) in the proximal or distal end. All cases undertook the autogenoas iliac crest bone grafting at the same time. The follow-up results were used to observe the fracture healing of the patients. The clinical effect of augmentation plating with bone grafting for aseptic nonunions of femoral shaft fractures after intramedullary nail fixation was evaluated according to the Tohner-Wrnch standard.
RESULTS AND CONCLUSION: All cases were followed-up for 6-21 months, average in 16 months. X-ray film showed that the bone healing rate was 100%; among the cases, 13 cases achieved osseous union within 6-9 months, while the other five patients achieved osseous union within 10-11 months. Tohner-Wrnch standard assessment results showed the bone healing rate of augmentation plating with bone grafting for aseptic nonunions of femoral shaft fractures after intramedullary nail fixation was 100%, no corrosion, breakage or hosting reaction of implant was found in all patients. Retaining the original intramedullary nail and augmentation plating with bone grafting for aseptic nonunions of femor

Key words: bone and joint implants, orthopedic implants, femoral shaft fracture, intramedullary nail, nonunion, augmentation plating, bone grafting, ilium, biocompatibility, implants, osseous union, clinical efficacy

CLC Number:

R318

Ru Jiang-ying, Cang Hai-bin, Hu Chuan-liang, Hu Yu-hua. Augmentation plating with bone grafting for nonunions of femoral shaft fractures after intramedullary nail fixation[J]. Chinese Journal of Tissue Engineering Research, 2013, 17(4): 604-611.

Figures/Tables 5

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