Is augmentation plating an effective treatment for non-union of femoral shaft fractures with nail in situ?

Autor: Jhunjhunwala HR; Department of Orthopaedics, Bombay Hospital Postgraduate Institute of Medical Sciences, Marine Lines, Mumbai, India., Dhawale AA; Department of Orthopaedics, Bombay Hospital Postgraduate Institute of Medical Sciences, Marine Lines, Mumbai, India. arjundhawale@hotmail.com.
Jazyk: angličtina
Zdroj: European journal of trauma and emergency surgery : official publication of the European Trauma Society [Eur J Trauma Emerg Surg] 2016 Jun; Vol. 42 (3), pp. 339-43. Date of Electronic Publication: 2015 Apr 29.
DOI: 10.1007/s00068-015-0534-8
Abstrakt: 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.
Databáze: MEDLINE
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