Augmentative Plate Fixation for Femoral Nonunion after Intramedullary Nailing

The purpose of this study is to evaluate the efficacy of augmentative plate fixation for the femoral nonunion after intramedullary nailing. We reviewed eleven femoral nonunion after intramedullary nailing, which were treated with augmentative plate internal fixation. All cases were initially managed with interlocking intramedullary nailing. Five were hypervascular and six were avascular. Leaving the intramedullay nail in situ, an augmentative plate fixation was applied to the fracture site to counter the rotational instability. A simultaneous bone grafting was performed in six avascular nonunion to repair the bony defect. The union time was 8.2 months in average( 7.8 months in hypervascular and 8.5 months in avascular). In conclusion, augmentative plating leaving the intramedullary nail in situ is an useful alternative for the treatment of femoral nonunion after intramedullary nailing. The technique is simple and does not require any special instruments. It facilitates an early weight bearing and 대한골절학회지 제13권, 제4호, 2000년 10월 The Journal of the Korean Society of Fractures Vol.13, No.4, October, 2000