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Year : 2019  |  Volume : 54  |  Issue : 1  |  Page : 40-44

Treatment of femoral and tibial fractures aseptic nonunion after intramedullary nailing by plate augmentation and bone graft

Department of Orthopaedic Surgery, Ain Shams University, Cairo, Egypt

Correspondence Address:
MD Ahmed H Yousry
34 Mohammed Tawfeek Diab Street, Nasr City, Cairo
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/eoj.eoj_12_19

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Objective Intramedullary nailing is widely used in the treatment of femoral and tibial fractures. But some patients suffer from nonunion after treatment by intramedullary nails. This paper investigates the methods and effects of augmentative compression plate and bone graft in the treatment of femoral and tibial nonunion after intramedullary nailing. Patients and methods Twenty patients treated between July 2009 and December 2014 were included in this retrospective study. The nonunions included 12 femora and 8 tibiae. The duration of nonunion ranged from 6 to 28 months. There were 7 women and 13 men with a mean age of 40 years (range, 21–64 years). Broad and narrow dynamic compression plating combined with bone grafting was the procedure chosen to treat every cases of femoral and tibial nonunion, respectively, in this series. Results The mean follow-up duration was 31.5 months (range, 10–52 months). All the femoral and tibial fractures achieved radiological union. The mean time to union was 20.8 months (range, 12–36 months). One patient had refracture of femoral shaft fracture after removal of interlocking nail and broad dynamic compression plate with refixation by interlocking nail and broad dynamic compression plate again with full union after 18 weeks. Apart from that case of refracture after hardware removal there were no serious complications such as infection, breaking or loosening of the plate and screws during the follow-up period. Conclusion Augmentation plating with bone grafting is a highly effective treatment for aseptic nonunion of the femur and tibia after intramedullary nailing.

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