Augmentative plate osteosynthesis with autologous bone grafting for aseptic non-union of femur with intramedullary interlocking nail in-situ: A prospective study

Abstract

Intramedullary interlocking nailing has become the gold standard of treatment for femoral shaft fractures with union rate approaching 97% (1, 2). In cases which have comminution at the fracture site however, interlocking nails alone fail to achieve union. This is specially true for fractures involving the metaphysis and metaphyseo-diaphyseal zone. The main reason for the resulting non-union is the failure of the interlocking nailing system not being able to provide adequate rotational stability of the fracture fragments. It is in these circumstances, that augmentative plate osteosynthesis along with autologous bone grafting gives sound union in 20 to 24 weeks. This prospective study was done on 24 patients who presented with aseptic non-union of the shaft of femur within 9 months of primary surgery, who had surgical augmentative plate osteosynthesis done along with autologous bone grafting and all went on to sound bony union, with an average union time of 22.7 weeks (range : 20 to 24 weeks).