Strategy for aseptic shaft nonunion of the lower extremities after intramedullary nailing:internal bone grafting combined with blocking screws / 中国矫形外科杂志

ABSTRACT

[Objective]To analyze the causes for aseptic shaft nonunion of the lower extremities after intramedullary nailing and to observe the therapeutic effects on bone nonunion by the combined technique of internal bone grafting with blocking screws.[Method]In 12 patients suffering from shaft aseptic nonunion of the low extremities(femur5 cases;tibia7 cases;hypertrophic nonunion 8 cases;atrophic nonunion4 cases),the therapeutic effects of the method of stabilizing the bone segments(exchanging larger nailing plus blocking screws technique),correcting bone deformity(blocking screws technique plus reduction finger) and reinforcing the bone healing capacity(internal bone grafting technique) were observed respectively.[Result]All patients were followed up for 1-2 years(mean 1.5 years) and all nonunions healed.The union rate was 100% and the period required to achieve union was 4.7-13.5 months(mean 7.8 months).All patients felt no pain at last and no complication occured.[Conclusion]Internal bone grafting combined with blocking screws is an effective treatment for aseptic nonunion of the lower extremities after intramedullary nailing.