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Published in: International Orthopaedics 7/2011

01-07-2011 | Original Paper

Failed intramedullary nailing of femur: open reduction and plate augmentation with the nail in situ

Authors: Galal Zaki Said, Hatem G. Said, Mohammad M. El-Sharkawi

Published in: International Orthopaedics | Issue 7/2011

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Abstract

Methods

Fourteen patients with aseptic fractures that failed to unite after intramedullary nailing (IMN) of the femur were treated by augmentation of fixation by dynamic compression plate (DCP) with the nail in situ. In six of them that had axial or rotational malalignment, direct reduction of the bone fragments and plating were done. Iliac bone grafting was performed in nine cases, when there were gaps between the fragments and in atrophic non-unions. Patients were followed-up for an average of 26 months.

Results

All patients had radiological union in an average of 4.3 months with an improvement in alignment, range of motion and shortening.

Conclusions

For failed IMN of the femur, augmentation of fixation by compression plate, with the nail in situ, is a good line of treatment. In cases with malalignment, correction was possible followed by plate augmentation.
Literature
1.
go back to reference Crowley DJ, Kanakaris NK, Giannoudis PV (2007) Femoral diaphyseal aseptic non-unions: is there an ideal method of treatment. Injury 38(Suppl 2):S55–S63PubMedCrossRef Crowley DJ, Kanakaris NK, Giannoudis PV (2007) Femoral diaphyseal aseptic non-unions: is there an ideal method of treatment. Injury 38(Suppl 2):S55–S63PubMedCrossRef
2.
go back to reference Hak, David J, Lee, Stanley S, Goulet, James A (2000) Success of exchange reamed intramedullary nailing for femoral shaft nonunion or delayed union. J Orthop Trauma 14:178–182PubMedCrossRef Hak, David J, Lee, Stanley S, Goulet, James A (2000) Success of exchange reamed intramedullary nailing for femoral shaft nonunion or delayed union. J Orthop Trauma 14:178–182PubMedCrossRef
3.
go back to reference Webb LX, Winquist RA, Hansen ST (1986) Intramedullary nailing and reaming for delayed union or nonunion of the femoral shaft. A report of 105 consecutive cases. Clin Orthop Relat Res 212:133–141PubMed Webb LX, Winquist RA, Hansen ST (1986) Intramedullary nailing and reaming for delayed union or nonunion of the femoral shaft. A report of 105 consecutive cases. Clin Orthop Relat Res 212:133–141PubMed
4.
go back to reference Furlong AJ, Giannoudis PV, DeBoer P, Matthews SJ, MacDonald DA, Smith RM (1999) Exchange nailing for femoral shaft aseptic non-union. Injury 4:245–249CrossRef Furlong AJ, Giannoudis PV, DeBoer P, Matthews SJ, MacDonald DA, Smith RM (1999) Exchange nailing for femoral shaft aseptic non-union. Injury 4:245–249CrossRef
5.
go back to reference Weresh MJ, Hakanson R, Stover MD, Sims SH, Kellam JF, Bosse MJ (2000) Failure of exchange reamed intramedullary nails for ununited femoral shaft fractures. J Orthop Trauma 14:335–338PubMedCrossRef Weresh MJ, Hakanson R, Stover MD, Sims SH, Kellam JF, Bosse MJ (2000) Failure of exchange reamed intramedullary nails for ununited femoral shaft fractures. J Orthop Trauma 14:335–338PubMedCrossRef
6.
go back to reference Jung HG, Kim DJ, Kim BH, Chung YY (2007) Treatment of the femoral shaft nonunion occurred after intramedullary nailing. J Korean Orthop Assoc 42:653–658CrossRef Jung HG, Kim DJ, Kim BH, Chung YY (2007) Treatment of the femoral shaft nonunion occurred after intramedullary nailing. J Korean Orthop Assoc 42:653–658CrossRef
7.
go back to reference Koval KJ, Seligson D, Rosen H, Fee K (1995) Distal femoral nonunion: treatment with a retrograde inserted locked intramedullary nail. J Orthop Trauma 9:285–291PubMedCrossRef Koval KJ, Seligson D, Rosen H, Fee K (1995) Distal femoral nonunion: treatment with a retrograde inserted locked intramedullary nail. J Orthop Trauma 9:285–291PubMedCrossRef
8.
go back to reference Brinker MR, O'Connor DP (2007) Exchange nailing of ununited fractures. J Bone Joint Surg Am 89:177–188PubMedCrossRef Brinker MR, O'Connor DP (2007) Exchange nailing of ununited fractures. J Bone Joint Surg Am 89:177–188PubMedCrossRef
9.
go back to reference Nadkarni B, Srivastav S, Mittal V, Agarwal S (2008) Use of locking compression plates for long bone nonunions without removing existing intramedullary nail: review of literature and our experience. J Trauma 65:482–486PubMedCrossRef Nadkarni B, Srivastav S, Mittal V, Agarwal S (2008) Use of locking compression plates for long bone nonunions without removing existing intramedullary nail: review of literature and our experience. J Trauma 65:482–486PubMedCrossRef
10.
go back to reference Ueng SW, Chao EK, Lee SS, Shih CH (1997) Augmentative plate fixation for the management of femoral nonunion after intramedullary nailing. J Trauma 43:640–644PubMedCrossRef Ueng SW, Chao EK, Lee SS, Shih CH (1997) Augmentative plate fixation for the management of femoral nonunion after intramedullary nailing. J Trauma 43:640–644PubMedCrossRef
11.
go back to reference Choi YS, Kim KS (2005) Plate augmentation leaving the nail in situ and bone grafting for non-union of femoral shaft fractures. Int Orthop 29:287–290PubMedCrossRef Choi YS, Kim KS (2005) Plate augmentation leaving the nail in situ and bone grafting for non-union of femoral shaft fractures. Int Orthop 29:287–290PubMedCrossRef
12.
go back to reference Rosen H (1988) Treatment of nonunions. In: Chapman MW, Madison M (eds) Operative Orthopedics. Lippincot, Philadelphia Rosen H (1988) Treatment of nonunions. In: Chapman MW, Madison M (eds) Operative Orthopedics. Lippincot, Philadelphia
13.
go back to reference Said GZ, Farouk O, Said HG (2009) Delayed union of multifragmentary diaphyseal fractures after bridge-plate fixation. Int Orthop 33:549–553PubMedCrossRef Said GZ, Farouk O, Said HG (2009) Delayed union of multifragmentary diaphyseal fractures after bridge-plate fixation. Int Orthop 33:549–553PubMedCrossRef
14.
go back to reference Menon DK, Dougall TW, Pool RD, Simonis RB (2002) Augmentative Ilizarov external fixation after failure of diaphyseal union with intramedullary nailing. J Orthop Trauma 16:491–497PubMedCrossRef Menon DK, Dougall TW, Pool RD, Simonis RB (2002) Augmentative Ilizarov external fixation after failure of diaphyseal union with intramedullary nailing. J Orthop Trauma 16:491–497PubMedCrossRef
15.
go back to reference Velazquez RJ, Bell DF, Armstrong PF, Babyn P, Tibshirani R (1993) Complications of use of the Ilizarov technique in the correction of limb deformities in children. J Bone Joint Sur-A 75:1148–1156 Velazquez RJ, Bell DF, Armstrong PF, Babyn P, Tibshirani R (1993) Complications of use of the Ilizarov technique in the correction of limb deformities in children. J Bone Joint Sur-A 75:1148–1156
16.
go back to reference Yun AG, Severino R, Reinker K (2000) Attempted limb lengthenings beyond twenty percent of the initial bone length: results and complications. J Pediatr Orthop 20:151–159PubMedCrossRef Yun AG, Severino R, Reinker K (2000) Attempted limb lengthenings beyond twenty percent of the initial bone length: results and complications. J Pediatr Orthop 20:151–159PubMedCrossRef
Metadata
Title
Failed intramedullary nailing of femur: open reduction and plate augmentation with the nail in situ
Authors
Galal Zaki Said
Hatem G. Said
Mohammad M. El-Sharkawi
Publication date
01-07-2011
Publisher
Springer-Verlag
Published in
International Orthopaedics / Issue 7/2011
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-010-1192-4

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