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Plate augmentation for femoral nonunion: more than just a salvage tool?
J C Chiang1, J E Johnson1, I S Tarkin2
1Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Objective:
The aim of the current study was to determine whether plate augmentation was a successful treatment algorithm for selected femoral nonunions initially managed with intramedullary nailing.
Materials And Methods:
A total of 30 femoral nonunion cases were managed using the plate augmentation strategy with 13 primary cases and 17 multi-operated femurs (avg 2.8 ineffective procedures). Adjunctive strategies included autologous bone grafting and/or BMP for atrophic/oligotrophic and bone defect cases. Deformity correction was performed when required.
Results:
Osseous union occurred in 29 of 30 cases. One multi-operated case with bone defect and prior infection required repeat autologous grafting prior to union.
Conclusion:
Plate augmentation should be added to the armamentarium for management of selected femoral nonunion that have failed initial intramedullary nailing.
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