Plate augmentation for the nonunion of femur shaft fractures after interlocking intramedullary nail fixation

Kim, Ki Soo; Kim, Ju O; Jung, Hyun Guyn; Jung, Byoung Oh

Abstract

Ten patients with nonunions of femoral shaft fractures were treated with plate augmentations and bone grafts. The patients sustained comminuted femoral shaft fractures and were fixed with interlocking intramedullary nails. Eight of the ten patients were inserted by closed technique and two were open. We followed the patients and waited for average 11.6 months, and during that periods, six of the ten patients received several procedures to facilitate union. But nails alone could not provide enough stability for the fracture unions. We exposed the nonunion sites, left the nails in situ, and applied additional plates with bone grafts. All nonunions were vascular and hypermobile, which could be corrected after plate applications. The patients were followed for at least 1 year(average 2.7 years), and all achieved radiologic solid unions after 7.7 months(average). No complications were noted. We believe that we can apply additional plates without removing previously inserted intramedullary nails for the hypermobile femoral shaft nonunions.