Modified CLON technique for treating femoral shaft nonunion with substantial shortening: A case report

The efficacy of the chipping and lengthening over nailing technique for treating severe femoral shaft nonunion with significant shortening remains ambiguous. A 51-year-old male with persistent femoral shaft nonunion despite multiple surgeries, including the traditional chipping and lengthening over nailing, was introduced to our institute. We utilized a two-stage modified version of the procedure. The first phase involved intramedullary nail removal, unilateral external fixator application, and the chipping technique. Following gradual lengthening via the external fixator, the second phase included the fixator's removal and internal fixation using an anterograde intramedullary nail. After three months, successful bone union with resolving leg length discrepancy was confirmed. The modified chipping and lengthening over nailing technique can effectively manage femoral shaft nonunion with considerable severe shortening, as evidenced in this case, ensuring successful bone healing and leg length discrepancy reduction.