A Clinical study on Non-union of the Femoral Shaft Fractures in Adults / 대한정형외과학회잡지

ABSTRACT

Femoral shaft fractures are usually accompanied with extensive soft tissue injury due to high energy force and are difficult to manage for functional stress with weight bearing. According to Boyd(1965), femoral shaft is the first of non-union among the long bone shafts. And because of inadequate internal fixation, poor immobilization and infection, non-union of femoral shaft is still of interest to all the orthopaedic surgeons. During past 10 years, 19 cases of non-union of the femoral shaft were treated at dept. of Orthopaedic Surgery, Ewha Womans University hospital and following results were obtained. l. Of 19 cases, male between 20-40th age group was predominent. Prevalent type and site was mid. 1/3 comminuted fractures(p > 0.05). 2. Initial treatment was 10 cases of intramedullary nailing; 8 of plate fixation; 1 of screw fixation. Bone graft was added to 10 cases. 3. The probable causes of non-union were complex; 11 of inadequate interal fixation, 4 of poor external immobilization and 4 of infection. 4. 4 cases of infection were managed with control of infection and fixation. And 11 cases were fixed with plate and the other 4, with intramedullary nailing. All were supplemented with autogenous bone graft. 5. Postoperative immobilization was done with 15 cases of hip spica cast and 4 of long leg cast for average 9.3 weeks. 6. All were united at average 8.9 months. Limitation of motion of knee was remained in 3 cases in spite of physiotherapy. Severe osteoporosis was noted in 3 cases and leg length shortening with limping was found in 1 case.