Exchange nailing for aseptic nonunion of the femoral shaft.

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.