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.
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.
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.