Arndt P Schulz1,2,3, Maximilian Faschingbauer4, Klaus Seide4, Uwe Schuemann4, Martin Mayer5, Christian Jürgens6,4, Michael Wenzl4. 1. BG Trauma Hospital Hamburg, Trauma and Reconstructive Surgery, Hamburg, Germany. aps77@web.de. 2. Department of Musculoskeletal Surgery, University Hospital Lübeck, Lübeck, Germany. aps77@web.de. 3. BG Trauma Hospital, Hamburg Trauma and Reconstructive Surgery, Bergedorfer Strasse 10, 21027, Hamburg, Germany. aps77@web.de. 4. Department of Musculoskeletal Surgery, University Hospital Lübeck, Lübeck, Germany. 5. Medical Faculty, University Hospital Lübeck, Lübeck, Germany. 6. BG Trauma Hospital Hamburg, Trauma and Reconstructive Surgery, Hamburg, Germany.
Abstract
OBJECTIVE: To analyse the results of the treatment of aseptic femoral non-unions using a singular locked implant. DESIGN: Consecutive case series. SETTING: A level-1 trauma center with a high number of specialist referrals. PATIENTS: The study is based on a consecutive series of patients with prospective data evaluation. From 1993 to 2003, 75 patients were treated with a wave plate. All patients had persistent non-union of the femoral shaft without clinical or laboratory signs of infection and previous unsuccessful attempts to treat the non-union. INTERVENTION: The method of treatment was standardized and included a lateral approach, cancellous bone hip grafting, osteosynthesis with a wave-shaped plate (PPF) and polyaxial locking screws as well as the application of a gentamicin-PMMA chain. MAIN OUTCOME MEASUREMENTS: Time to achieve union, rate of implant failure and number of remaining nonunions after treatment. A total of 75 patients had full follow-up and were included in the study. RESULTS: The union of the fracture was found in 64 patients after the initial procedure. In eight cases a second procedure was performed to achieve union in the form of a second bone graft because of a delay in callus formation. The mean time to union was 7.3 months with a range from 3 to 19 months. The implant failed in three cases accounting for 4% of the total. CONCLUSION: The locked wave plate offers a further reliable treatment for complex aseptic femoral non-unions.
OBJECTIVE: To analyse the results of the treatment of aseptic femoral non-unions using a singular locked implant. DESIGN: Consecutive case series. SETTING: A level-1 trauma center with a high number of specialist referrals. PATIENTS: The study is based on a consecutive series of patients with prospective data evaluation. From 1993 to 2003, 75 patients were treated with a wave plate. All patients had persistent non-union of the femoral shaft without clinical or laboratory signs of infection and previous unsuccessful attempts to treat the non-union. INTERVENTION: The method of treatment was standardized and included a lateral approach, cancellous bone hip grafting, osteosynthesis with a wave-shaped plate (PPF) and polyaxial locking screws as well as the application of a gentamicin-PMMA chain. MAIN OUTCOME MEASUREMENTS: Time to achieve union, rate of implant failure and number of remaining nonunions after treatment. A total of 75 patients had full follow-up and were included in the study. RESULTS: The union of the fracture was found in 64 patients after the initial procedure. In eight cases a second procedure was performed to achieve union in the form of a second bone graft because of a delay in callus formation. The mean time to union was 7.3 months with a range from 3 to 19 months. The implant failed in three cases accounting for 4% of the total. CONCLUSION: The locked wave plate offers a further reliable treatment for complex aseptic femoral non-unions.
Entities:
Keywords:
Femoral fractures; Intramedullary nailing of long bones; Locked plate; Non-union; Proximal femoral and femoral shaft fractures; Psaeudoarthrosis; Revision surgery