Simple bone grafting versus dynamization of locking compression plate combined with autologous bone grafting for femoral aseptic nonunion / 中华创伤骨科杂志

ABSTRACT

Objective:To compare the clinical effects between simple bone grafting and dynamization of locking compression plate (LCP) combined with autologous bone grafting in the treatment of femoral aseptic nonunion.Methods:In this retrospective study, 30 patients with femoral aseptic nonunion were included who had been treated from January 2010 to January 2020 at Department of Orthopaedics, General Hospital of Central Theater Command of Chinese People’s Liberation Army. They were 19 males and 11 females, with an age from 25 to 55 years. Of them, 12 were subjected to LCP dynamization combined with autologous bone grafting (group A) and 18 to simple bone grafting (group B). The 2 groups were compared in terms of surgical indicators, fracture healing time, Hospital for Special Surgery (HSS) knee scores at preoperation and 12 months postoperation and Lane-Sandhu radiographic scores at 1, 3, 6 and 12 months postoperation.Results:As there was no statistically significant difference in general information between the 2 groups, they were comparable ( P>0.05). The fracture healing time in group A [(8.2±1.7) months] was significantly shorter than that in group B [(9.8±2.2) months] ( P<0.05). There was no significant difference between the 2 groups in Lane-Sandhu radiographic score at 1 month postoperation ( P>0.05). The Lane-Sandhu radiological scores in group A at 3, 6, and 12 months postoperation (4.2±1.2, 8.4±0.7 and 10.8±0.9) were significantly higher than those in group B (3.3±0.9, 7.1±1.3 and 9.8±1.2) ( P<0.05). There was no statistically significant difference between the 2 groups in preoperative HSS knee score ( P>0.05). The HSS knee score at 12 months postoperation in group A (83.3±4.3) was significantly higher than that in group B (76.2±4.1) ( P<0.05). Conclusion:In the treatment of femoral aseptic nonunion, compared with simple bone grafting, LCP dynamization combined with autologous bone grafting may shorten fracture healing time, improve bone formation, and thus lead to better therapeutic efficacy.