Treatment of nonunion following intramedullary nailing of femoral and tibial fractures / 中华创伤骨科杂志

ABSTRACT

Objective To explore diagnosis of nonunion following intramedullary nailing of femoral and tibial fractures and the treatment of nonunion of femoral and tibial fractures with Less Invasive Stabilization System (LISS) or locking compression plate (LCP). Methods From February 2003 to December 2004, 7 cases of nonunion after intramedullary nailing of femoral and tibial fractures were diagnosed by X-ray or CT scanning or CT-3D. LISS or LCP fixation and bone grafting were employed to treat the 7 cases of nonunion in the femur and tibia. Their case histories ranged from 10 to 49 (mean 23.3) months. Results All the 7 patients were followed up for a mean of 9.1 (4 to 16) months. The bone union time for all the fractures averaged 4.7 months (ranging from 4 to 6 months). No loosening or breakage of the implants occurred in this series. Conclusions The operation should be done for the patients who feel pain in the lower extremities or the fracture line still exists at the fracture ends long time after intramedullary nailing. In order to improve the healing of bone fractures, micromovement and bone defects at the fracture site should be eliminated. Because of its merits in design, the LISS can be used to effectively treat nonunion at the distal femur or the proximal tibia.