Exchange nailing with Uni-cortical plate augmentation +/- bone grafting for proximal 2/3rd distal 1/3rd junction shaft non-union femur

Author(s): Dr. Anshul Sethi, Dr. Aditya Kumar Mishra, Dr. Mohd. Bilal Kaleem, Dr. Navneet Badoni, Dr. Amish Bhandari, Dr. Pankaj Singh, Dr. Vishal Haldar, Dr. Raunaq Saxena and Dr. Sulabh Maheshwari

Abstract: The femur is prone to fracture when struck by strong external forces, such as in motor vehicle accidents, falling from height. Intramedullary nailing (IMN) has achieved good results in the treatment of adult femoral shaft fractures. However, poor blood supply and severe soft tissue damage often result from inappropriate surgical operations or deep infection, leading to delayed union or bone non-union. The incidence of non-union of femoral fractures after trauma is 5%–10%. The treatment options available to deal with NON-UNION include Exchange Nailing, removal of the nail, and Re-osteosynthesis with plating +/- Bone grafting, or Ilizarov fixation. We present our experience of plate augmentation with Exchange nailing +/- bone grafting for non-union at junction of proximal 2/3rd and distal 3^rd of femoral fractures. It is an efficient technique, which provides additional rotational stability at the non-union site, the additional advantages of this technique are that it can be done with minimally invasive technique, allows early rehabilitation of the patient, and carries lesser morbidity.

DOI: https://doi.org/10.22271/ortho.2021.v7.i3f.2781