Result of Femoral Fracture Nonunion Surgery with Plating and Bone Graft

Close reduction and intra medullary nailing has been established as the treatment for femoral shaft fractures with a nonunion rate of 0. 9-1. 1 %; though، it is still controversial. Currently، the most accepted method for treatment of non union is exchange nailing. Therefore، this study aimed to investigate treatment of femoral shaft fractures non union via 2 methods of exchange nailing with bone graft and nail removal، and plating with bone graft.

In this case series study، we included all patients with aseptic nonunion femoral fracture who referred to Rasool-Akram hospital from 2007 to 2012 and were clinically indicated for reoperation for nonunion after primary intra medullary nailing. Patients were assessed clinically and radiologically. The patients were treated via either method according to the type of nonunion (atrophic، oligotrophic، hypertrophic). Collected data were recorded in check lists and analyzed with SPSS V. 18 software.

Of 23 patients with mean age of 30. 4±8. 5 years، 13 (56%) were treated by exchange nailing with bone graft and 10 (44%) treated by plating and bone graft. Complete union was achieved in 85. 7% of patients treated by exchange nailing and bone graft and in 90. 9 % of patients treated with plating with bone graft. No leg length discrepancy، pain and infection were reported.

This study suggests that treatment results of nonunion femoral fractures with plating bone graft method is as good as or even better than exchange nailing with bone graft. In addition، the prevalence of femoral fracture nonunion seems to be more than what was expected before.