Augmentation plating leaving the nail in situ is an excellent option for treating femoral shaft nonunion after IM nailing: a multicentre study.

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Abstract

[Indexed for MEDLINE] 6. Zhongguo Gu Shang. 2016 Aug 25;29(8):723-728. doi: 10.3969/j.issn.1003-0034.2016.08.010. [Treatment of distal femur nonunion with bone defect by less invasive stabilization system and fibular strut graft]. [Article in Chinese] Gao KD(1), Wang QG(2). Author information: (1)Department of Traumatic Orthopaedics, Shanghai General Hospital of Nanjing Medical University, Shanghai 201620, China. (2)Department of Traumatic Orthopaedics, Shanghai General Hospital of Nanjing Medical University, Shanghai 201620, China; wangqiugen@163.com. OBJECTIVE: To evaluate the therapeutic effects of less invasive stabilization system distal femur (LISS-DF) combined with fibular struts graft for distal femur nonunions and bone defects. METHODS: A total of 12 patients with distal femur nonunion and bone defect were underwent revision operation with locked plating, plus a nonvascularized autologous fibular strut bone graft from June 2007 to September 2014, including 10 males and 2 females with an average age of (56.2±14.1) years old ranging from 30 to 77 years old. The mean time from the initial trauma to the last revision operation was (16.4±5.5) months (ranged from 9 to 26 months). All cases were atrophic nonunions according to Weber-Cech classification and type B1 (bone loss) according to Paley classification. All patients were followed up and evaluated with clinical and imaging results. The KSS (American Knee Society Score) scores including knee clinical score and knee functional score were compared before and after the treatment. RESULTS: All patients were followed up from 12 to 17 months with an average of (13.7±1.9) months. All nonunions healed with an average time of (6.2±1.3) months (ranged from 4 to 8 months). The average range of movement (ROM) of the knee was improved from (67.1±29.6)° preoperatively to (102.5±13.6)° at the last follow up. KSS scores including knee pain, range of motion, clinical and functional score were significantly different before and after operation. No such complications as infection, hardware loosening or breakage occurred postoperatively. CONCLUSIONS: LIFF-DF fixation and autologous fibular strut bone graft facilitated the successful treatment of distal femur nonunions with bone defects. DOI: 10.3969/j.issn.1003-0034.2016.08.010