Management of diaphyseal femur fracture non-union with an antirotatory plate osteosynthesis
DOI:
https://doi.org/10.1016/S0120-8845(13)70013-0Keywords:
femoral fractures, fractures, non-union, fracture fixation, intramedullary, bone nails, bone transplantation, fracture healing, retrospective studies, evidence level: IVAbstract
Introduction: Every year, there are 250 patients admitted with femoral shaft fracture at our institution. For patients treated with reamed and locked femoral nails, the non-union rate is between 10 to 15%, similar to worldwide incidence. Treating non-union is a challenge because healing rates are of only 50–80% with actual techniques. A novel technique is presented: augmentation with an antirotatory plate.
Materials and methods: We conducted a case series study at two university hospitals, collecting information from patients with diaphyseal femur fracture non-union, treated with antirotatory plate and bone grafts between 1997 and 2008. Clinical and radiological variables were assessed.
Results: 47 patients entered the study, with 48 nonunion fractures of the femoral shaft that had been treated with reamed intramedullary interlocking nail. 30 fractures (62%) had required an open reduction. The average age was 37 years. 44 fractures (92%) healed 6 months after treatment with antirotatory plate and autologous bone grafts.
Discussion: This method promotes both biology and mechanics in the fracture site, allowing bone healing and return to normal activities in a high percentage. We recommend it for the treatment of femoral non-union. Further prospective research may confirm the safety and effectivity of this treatment.
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