Proximal femur fracture non-union with or without implant failure: A revision technique with clinical outcomes

Abstract

Background: This manuscript presents a revision surgical technique with clinical outcomes for the management of inter and subtrochanteric femur fracture non-union with or without implant failure.

Methods: Between January 2010 and January 2019, consecutive patients presenting with inter and subtrochanteric femur fracture non-union and/or implant failure managed with exchange intramedullary nailing, LCP augmentation and biological supplementation were identified. Patient demographics and perioperative data was recorded.

Results: 13 patients with 10 intertrochanteric and 3 subtrochanteric femur fractures were identified. Revision was performed for implant failure in 8 (62%) patients and non-union in 5 (38%) patients. Fracture union occurred in all patients at an average of 9 months post revision.

Conclusions: Exchange intramedullary nailing, with LCP augmentation and biological supplementation is an effective technique to restore anatomy, maintain function and facilitate immediate weight bearing while providing a fixation construct able to withstand the often extended time periods required to achieve fracture union.

Keywords: Implant failure; Intertrochanteric femur fracture; Non-union; Revision surgery; Subtrochanteric femur fracture.