AUGMENTATIVE PLATE FIXATION FOR THE MANAGEMENT OF FEMORAL NONUNION AFTER INTRAMEDULLARY NAILING

Seventeen femoral nonunions after intramedullary nail internal fixatio n were treated with augmentative plate internal fixation, Six of them were initially managed with a Kuntscher nail internal fixation; the ot her 11 fractures were managed with a locked nail internal fixation. Al l the femoral nonunions were caused by insecure fixation of the intram edullary nailing, in which a rotational instability of the fracture si te was verified in all cases during operation. Leaving the intramedull ary nail in situ, an augmentative plate fixation was applied to the fr acture site to counter the rotational instability. A simultaneous bone grafting was performed in seven of them to repair the bony defect, Al l these patients walked bearing full weight on the extremity without a ching at the fracture site within 3 months and all these 17 fractures obtained a bony union within an average of 7 months after this treatme nt. From our experience, we have found this method is a useful treatme nt for the nonunion of the femoral shaft fracture after an intramedull ary nail internal fixation. The technique is simple and does not requi re any special instrument. It facilitates an early weight bearing and gives a quick recovery from nonunion.