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. 2005 Oct;29(5):287-90.
doi: 10.1007/s00264-005-0668-0. Epub 2005 Aug 31.

Plate augmentation leaving the nail in situ and bone grafting for non-union of femoral shaft fractures

Y S Choi  1 , K S Kim
Affiliations

Plate augmentation leaving the nail in situ and bone grafting for non-union of femoral shaft fractures

Y S Choi et al. Int Orthop. 2005 Oct.

Abstract
in English, French

We reviewed 15 patients with femoral non-union after interlocking intramedullary nailing treated with plate augmentation and bone grafting with the nail in situ. The mean time from primary nailing to plate augmentation and bone grafting was 10 months. At the time of presentation, the patients had undergone an average of 1.6 operations from the time of their original injury. To achieve stability of the fracture, we applied an AO plate on the lateral aspect of the femur. The retained nail maintained alignment of the fracture, and plating did not require an extensive surgical approach. In all patients, there was visible motion at the fracture site; however, the motion disappeared after plate augmentation. All patients achieved radiological solid union at an average of 7.2 months.

Nous avons suivi 15 malades avec une pseudarthrose fémorale après enclouage centromédullaire traitée avec une plaque supplémentaire et une greffe osseuse en laissant le clou en place. Le délai moyen entre l’enclouage initial et la reprise chirurgicale avec plaque et greffe était de 10 mois. Au moment de l’étude les malades avaient subi une moyenne de 1,6 opérations à dater du traumatisme. Pour obtenir la stabilité de la fracture, nous avons utilisé une plaque externe AO. Le clou laissé en place a maintenu l’alignement de la fracture et la mise en place de la plaque n’a pas exigé un abord chirurgical étendu. Chez tous les malades il y avait une mobilité du foyer de fracture qui a disparue après l’ostéosynthèse par la plaque. Tous les malades avaient une consolidation radiologique solide à une moyenne de 7,2 mois.

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Figures

Fig. 1
Fig. 1
a An 18-year-old man with comminuted femoral shaft fractures treated with interlocking intramedullary nailing. b Six months after initial operation, the nail was exchanged to a larger one after reaming; 10 months after exchange nailing, there was still a gap of the fracture and loose distal locking screw. c Plate augmentation and exchanging distal locking screw was performed to provide stability, and bone graft was done to promote union; 8 months after plate augmentation, a bony union was obtained without complications
Fig. 2
Fig. 2
a A 21-year-old man with non-union of a distal-third fracture of the femur that was treated with plate augmentation at 15 months after initial operation. b Eleven months after plate augmentation, radiographs revealed the screws were loosened; but 36 months after the last operation, bony union was obtained without complications, and removal of the interlocking nail was done
See this image and copyright information in PMC

Comment in

References

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