J Korean Fract Soc.  2003 Apr;16(2):155-162. 10.12671/jksf.2003.16.2.155.

Treatment of Femoral Shaft Nonunions with Dynamic Compression using Interlocking-Compression (IC) Nail

Affiliations
  • 1Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. yspark@smc.samsung.co.kr

Abstract

PURPOSE: To evaluate the effectiveness of a specially designed Interlocking-Compression Nail (IC Nail(R), Osteo, Switzerland) which allows compression force across the nonunion site for the treatment of femoral shaft nonunions.
MATERIALS AND METHODS
Between Nov. 1998 and June 2002, twenty one nonunions of femoral shaft fractures in twenty patients were treated with reamed IC nails of larger diameters without bone grafting in 9 men and 11 women, 8 to 45 months after initial operations. Seventeen cases were hypervascular nonunions, 3 avascular, and 1 infected. For initial operation, 10 closed nailing, 10 open nailing and 1 plate fixation were performed. One or more additional procedures had been done in 17 cases prior to IC nailing.
RESULTS
The nonunion gap was considerably narrowed from 7.4 mm to 3.1 mm with IC nailing and bony unions were achieved in all but one case. The time for radiographic union was 4 to 15 months posteoperatively with an average of 7.4.
CONCLUSION
Reamed IC Nail(R) with a larger diameter is an effective procedure for femoral shaft fracture nonunion regardless of initial treatment modalities and even in 3 avascular nonunions, 2 have shown radiographic union without bone grafting. Additional procedures are to be considered in failed surgery of avascular nonunions.

Keyword

Femoral shaft fracture; Nonunion; IC (Interlocking-Compression) nail

MeSH Terms

Bone Transplantation
Female
Humans
Male
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