Interlocking nailing and reaming for nonunion of the femoral shaft

ABSTRACT

Twenty-four consecutive patients with a diagnosis of nonunion of the femoral shaft from 1998 to 2004 were managed by intramedullary reaming and interlocking nailing Adequate follow-up study was obtained in all patients; all but three showed radiologic union at an average of 24 weeks following the procedure, with an overall union rate of 87.5%. The three patients whose fractures failed to consolidate with this treatment had reoperation with simultaneous dynamization and bone grafting. This resulted in healing in 2 of the 3 cases. We concluded that intramedullary nailing with reaming is the optimal treatment for the patient with aseptic nonunion of the femoral shaft If faced with failure to consolidate with this treatment, bone grafting in situ or closed reamed exchange nailing would be prefered instead of dynamization which might result in unacceptable shortening or hardware failure