H R Jhunjhunwala1, A A Dhawale2. 1. Department of Orthopaedics, Bombay Hospital Postgraduate Institute of Medical Sciences, Marine Lines, Mumbai, India. 2. Department of Orthopaedics, Bombay Hospital Postgraduate Institute of Medical Sciences, Marine Lines, Mumbai, India. arjundhawale@hotmail.com.
Abstract
PURPOSE: There are few reports of non-union femur shaft fractures treated with plate fixation with the nail in situ. This study reports our results in 40 cases. METHODS: Retrospective series of non-union and delayed union of femoral shaft after intramedullary nailing treated with plate fixation. Patients were serially followed-up till 12 months. Fracture union, time to union, knee range of motion, deformity, shortening and complications were recorded. Descriptive statistics were performed as applicable. RESULTS: There were 40 patients with mean age of 35 years (18-65). There were 14 cases of hypertrophic non-union, 24 cases of atrophic non-union and 2 cases of delayed union. The average time of surgery was 1 ½ h and average blood loss was 300 ml. Exchange nailing was done in 9 cases. Union was achieved in 39 patients. The mean time to fracture union was 4 months. Post-operative knee range of motion was >120° in 35 patients. One patient developed deep infection which was treated with removal of implants and exchange nailing with a vancomycin coated nail and union was achieved. CONCLUSION: Plating is an effective treatment for non-union of diaphyseal femur fractures after intramedullary fixation with the nail in situ.
PURPOSE: There are few reports of non-union femur shaft fractures treated with plate fixation with the nail in situ. This study reports our results in 40 cases. METHODS: Retrospective series of non-union and delayed union of femoral shaft after intramedullary nailing treated with plate fixation. Patients were serially followed-up till 12 months. Fracture union, time to union, knee range of motion, deformity, shortening and complications were recorded. Descriptive statistics were performed as applicable. RESULTS: There were 40 patients with mean age of 35 years (18-65). There were 14 cases of hypertrophic non-union, 24 cases of atrophic non-union and 2 cases of delayed union. The average time of surgery was 1 ½ h and average blood loss was 300 ml. Exchange nailing was done in 9 cases. Union was achieved in 39 patients. The mean time to fracture union was 4 months. Post-operative knee range of motion was >120° in 35 patients. One patient developed deep infection which was treated with removal of implants and exchange nailing with a vancomycin coated nail and union was achieved. CONCLUSION: Plating is an effective treatment for non-union of diaphyseal femur fractures after intramedullary fixation with the nail in situ.
Authors: Ioannis D Gelalis; Angelos N Politis; Christina M Arnaoutoglou; Anastasios V Korompilias; Emilios E Pakos; Marios D Vekris; Athanasios Karageorgos; Theodoros A Xenakis Journal: Injury Date: 2011-07-08 Impact factor: 2.586