Femoral shaft healing disorder biomechanics and biology case report

Nonunion is one of the common fracture healing complications. Its diagnosis is based on clinical and X-ray/CT findings. Nonunions can be classified, according to Weber and Cech, as vital and nonvital. Low mechanical stability is the main underlying factor in the development of vital nonunions and therefore, the treatment should be focused on increasing their stability. Absence of biological activity is the causal factor in the development of nonvital nonunions; thus the therapy must be bolstered by bone grafting and decortication. Treatment of nonunions is time consuming and costly and the frequency of their incidence is not decreasing. However, significant progress has been made in the treatment of patients with this bone healing defect over the last decades owing to improved understanding of its genesis and the development of osteosynthetic materials. The presented case of nonunion after periprosthetic fracture includes a detailed description of the therapeutic considerations and techniques used in subsequent phases of treatment, accompanied by radiologic and pictorial documentation. Six months after application of a wave plate, the nonunion was successfully healed. The wave plate is a rarely used implant in our countries; however, its specific biomechanical and biological characteristics significantly support healing of indicated diaphyseal nonunions.