Plate Augmentation for Nonunion of Femoral Shaft Fractures

Femoral nonunion is an important complication, which can occur after intramedullary nailing and it requires surgical intervention. Plate augmentation over intramedullary nail is emerging as an acceptable option with satisfactory results for femoral nonunion. The aim of the present study was to determine whether plate augmentation over retained intramedullary nail is an effective treatment for nonunion of femoral shaft fracture. Overall, 35 cases of femoral nonunion, initially treated with intramedullary nailing, were managed with plating augmentation. Patients with oligotrophic or atrophic nonunion also received iliac cancellous auto graft. The outcome was evaluated by the rate and duration of union and complications were recorded. All patients achieved bony union during an average time of 21 weeks (± 3.94) and no union occurred later than 35 weeks. In plain radiography, evidence of callus formation was seen at mean time of 10 weeks. There was no statistically significant difference in union time among different types of nonunion (P: 0.466) while a significant difference was noticed in the time for callus formation (P < 001). Also, no complications were observed. Plating augmentation is an effective and safe treatment option for nonunion of femoral shaft fractures.