Double locking plate fixation for femoral shaft nonunion

Nonunions after operative fixation of the femur, although infrequent, remain a challenge for orthopedic surgeons. The aim of this study was to assess the effectiveness of double locking plate fixation in the treatment for femoral shaft nonunions.

From 2009 to 2013, 21 patients with femoral nonunions (mean age 46.9 years, range 25-81) were treated and evaluated utilizing double locking plate fixation. Patients were followed for at least 6 months postoperatively or until they achieved complete union to investigate bone healing and functional outcomes in femoral shaft nonunions treated with double locking plate and autogenous cancellous bone graft.

The main outcomes evaluated were the presence of bony union, time to achieve union, and SF-36 score. All 21 femoral nonunions healed (100 % union rate). The average time to bony union was 5.3 months (range, 4-7). The mean follow-up duration time was 24.8 months (range, 6-60). Average scores of the physical function and bodily pain components of the SF-36 were 96 (range, 90-99) and 94.2 (range, 92-99), respectively. No significant complications were noted postoperatively.

Because of the high union rates and lack of significant complications in our series, double locking plate fixation can serve as an effective method of addressing femoral shaft nonunions. No significant complications were found postoperatively.