Comparing the Effect of Reamed Exchange Nailing and Augmentation Compression Plating in Treatment of Femoral Shaft Nonunion

Abstract

Background and purpose: One of the most important complications of bone fractures is nonunion. This research aimed at comparing the effect of exchange nailing and plate augmentation on complications after surgery and the time to achieve desired outcomes. Materials and methods: This descriptive-analytical study was conducted in 12 femoral shaft nonunion cases treated operatively in 2011-2018 (eight patients were managed with plate augmentation and four patients were treated with exchange nailing). Demographic characteristics of the patients, type of fracture and type of surgery were recorded. A year after the surgery, anteroposterior and lateral view profiles were prepared from all patients and the extent of bone fusion was evaluated by orthopedic surgen. Results: Four patients (33.33%) underwent intraosseous nail replacement surgery and eight (66.67%) underwent plate augmentation surgery. Two patients (16.67%) developed infections and five (41.67%) had a short limb complication. The average limb shortness in these patients was 1.10±0.22 cm. The average duration of union after discharge was lower in patients with plate augmentation than those with replacement of the intramedullary nail. Conclusion: In current study, faster uninon achieved, so, augmentation plating could be a good choice in patients with femoral shaft nonunion.

Keywords

• femoral shaft
• nonunion
• plate augmentation
• exchange nailing