Study of outcome of treatment for nonunion of femoral shaft fractures: A case series

Abstract

Introduction: Nonunion of femoral shaft fractures continues to hinder the successful outcome femur fracture treatment in spite of increased understanding of biomechanics and improvements of implant design. Nonunion of femur fracture presents a difficult treatment challenge for the surgeon and a disastrous personal and economic hardship for the patient. Method and Material: 20 consecutive cases of fractures shaft of femur non-union were admitted to the Orthopaedics Department, Dhiraj Hospital, Waghodia were included in this study. All patients underwent revision surgery in form of exchange nailing with autologous cancellous bone graft with plate augmentation in required cases. Results: Out of 20 patients maximum belonged to the age group of 31-40(8). 13 (65%) patient had hypertrophic non-union and 7 (35%) had atrophic non-union. Average follow up of patients was upto 14 months post operatively. Out of 20 patients, 14 (70%) patient achieved union at their last follow up. Radiological signs of bone union was observed at a average of 7.5 months (5.5 to 11 months). Discussion and Conclusion: The use of plate augmentation and bone grafting for the treatment of femoral shaft nonunion, along with exchange interlocking intramedullary nail, to remove the rotational instability of the nonunion site increased the chances of union. Bone grafting performed simultaneously filled the bony defect and stimulated healing.