Repair of nonunion after femoral shaft fracture with double plate fixation and bone grafting: stabilize three-dimensional fixation

doi:10.3969/j.issn.2095-4344.2014.53.015

Abstract

Abstract:

BACKGROUND: Nonunion is a common complication of fractures. Reasons and mechanisms of causing femoral shaft nonunion are very complex. The reasons are improper surgical procedures, improper fixation material selection, incorrect reset or arbitrary abandonment of bone fragments after comminuted fracture, and improper postoperative functional exercise. It is still controversial to choose a repair method for nonunion after femoral shaft fracture surgery.
OBJECTIVE: To analyze the clinical results of double plate fixation and bone grafting for repair of nonunion after femoral shaft fracture.
METHODS: From June 2010 to August 2012, 14 cases of noninfectious nonunion of femur were treated with bone grafting and double plates. There were 9 males and 5 females, mean age of 36.2 years (range 22 to 49 years). The nonunion had resulted from failure of more than once internal fixation in 9 cases, including plates, intramedullary nails and nail dynamization, as well as failure of once internal fixation (plate fixation or intramedullary nailing fixation) in 5 cases. According to the Judet classification, there were 8 cases of hypertrophic nonunion and 6 cases of atrophic nonunion. The history of nonunion lasted from 11 to 46 months, mean 26.2 months. During postoperative regular follow-up, the clinical results of double plate fixation and bone grafting for repair of nonunion after femoral shaft fracture were observed.
RESULTS AND CONCLUSION: All patients were followed up for 10 to 25 months. All cases healed after a mean duration 5.2 months (range 4-7 months), without wound infection, fixation loosening or breakage. Due to three-dimensional fixation, strong stability and fully bone graft, double plate fixation and bone grafting are in line with the required mechanical fracture healing environment, and simple to be operated. Intraoperative soft tissue and periosteal stripping and blood supply damage are adequate, with less complication. These results confirmed that double plate fixation and bone grafting can effectively repair nonunion after femoral shaft fracture.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

全文链接：

Key words: femur, fractures, ununited, internal fixators, follow-up studies

CLC Number:

R318

Abduaziz•Mamat, Ali•Rehi, Askar•Mamtimin, Mamatkirmolla•Tursunjan. Repair of nonunion after femoral shaft fracture with double plate fixation and bone grafting: stabilize three-dimensional fixation[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(53): 8607-8611.

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