Exchange nailing for aseptic nonunion of the femoral shaft.

Department of Orthopedics, Chang Gung Memorial Hospital, Kweishan, Taoyuan, Taiwan.
International Orthopaedics (Impact Factor: 2.02). 02/2002; 26(2):80-4.
Source: PubMed

ABSTRACT Thirty-six nonunions of the femoral shaft were treated by closed removal of previous nails, reaming of marrow cavity as widely as possible, and reinsertion of stable intramedullary nail. Indications included femoral shaft aseptic nonunions with inserted intramedullary nail, nonunions with a radiolucent line, without segmental bony defects, and less than 1 cm shortening. They were followed up for a median of 2.9 (1-6) years. Thirty-three nonunions healed uneventfully within a median period of 4 (3-8) months. Except for three persistent nonunions, no other significant complications occurred.

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    ABSTRACT: PurposeThis retrospective study was to report the experience in treating femoral shaft aseptic nonunions associated with breakage of distal locked screws.
    Hydrometallurgy 02/2011; 2(1):2-6. DOI:10.1016/j.fjmd.2010.12.008 · 2.22 Impact Factor
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    ABSTRACT: Background The aim of this study was to evaluate a standardized method of treatment of femoral nonunion of the isthmal femur excluding non-united metaphyseal fractures.Methods Between 2003 and 2010, 72 consecutive patients with nonunion of the femoral shaft were operated using a standardized protocol in our trauma department and followed up for successful union and functional result.ResultsOsseous healing was observed in 71 patients (98%). Only one patient was lacking bone healing following a time period of 24 months after the first exchange nailing and 5 months after the second exchange nailing. In 59 patients (82%), uneventful and timely bone healing after exchange nailing was detected. In 18% of patients (n = 13), delayed bone healing was observed and required additional therapy. In the majority of patients (61%), bone healing occurred within the first 2 to 5 months, only 18% of patients¿ duration of bone healing exceeded 8 months. In 62 patients (86%), no relevant or clinically apparent leg-length discrepancy prior to and after exchange nailing was detected as well as no significant axis deviation or malrotation. Functional studies including simple clinical gait and standing analysis, return to activities of daily life, return to sports activities, and return to work were all reached on a satisfying level.DiscussionReamed intramedullary exchange nailing as described in this study is the treatment of choice for aseptic femoral shaft nonunion with a high rate of bone healing and a low rate of complications including length discrepancy or malrotation and a good functional outcome.
    Journal of Orthopaedic Surgery and Research 10/2014; 9(1):88. DOI:10.1186/s13018-014-0088-1 · 1.58 Impact Factor
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    ABSTRACT: Purpose We assessed indications and outcomes of exchange nailing and augmentation plating for femoral shaft nonunion following femoral nail failure. Methods We retrospectively reviewed the records of 21 consecutive patients with femoral shaft nonunion treated with femoral nailing from August 2008 to June 2013. Nonunion cases with infection were excluded from this study. The study population consisted of nine men and 12 women, with an average age of 40 (range 21-61) years. All patients received internal fixation using exchange nailing and an augment plate coupled with decortication and bone graft. Results All patients in our study obtained osseous union with a mean time of six (range four to 12) months. Mean operation time was three hours (range two to five hours), and mean blood loss was 800 ml (range 500-950 ml). There were no postoperative complications. At the last follow-up, all patients could flex their knees > 110 degrees. Conclusions Exchange nailing and augment plating coupled with decortication and bone graft is an effective treatment option for femoral shaft nonunion and has more indications and higher union rate than the popular exchange nailing treatment.
    International Orthopaedics 07/2014; 38(11). DOI:10.1007/s00264-014-2456-1 · 2.02 Impact Factor


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