Augmentation Plating with Intramedullary Nailing for Aseptic Long Bone Non-union: A Prospective Observational Study...

Area of Science:

• Orthopedic Surgery
• Trauma Surgery
• Bone Healing Research

Background:

• Non-union of long bone fractures after intramedullary nailing (IMN) presents a significant clinical challenge.
• Augmentation plating provides enhanced rotational stability without necessitating nail removal, reducing patient morbidity.

Purpose of the Study:

• To prospectively evaluate the clinical, radiological, and functional outcomes of augmentation plating with selective autologous bone grafting for aseptic femoral and tibial non-unions.

Main Methods:

• Thirty patients with aseptic diaphyseal non-unions of the femur or tibia underwent augmentation plating and bone grafting.
• Radiological healing was assessed using the modified Radiographic Union Score for Tibia (mRUST).
• Functional recovery was measured by the lower extremity functional scale (LEFS) and Wu's criteria.

Main Results:

• A 100% union rate was achieved across all 30 patients, with a mean healing time of 6.23 months.
• Significant improvements were observed in mRUST scores (5.17 to 15.33) and LEFS scores (31.77 to 76.60).
• 60% of patients achieved excellent and 30% achieved good functional outcomes per Wu's criteria, with a 10% complication rate.

Conclusions:

• Augmentation plating with selective autologous bone grafting is a highly effective revision strategy for aseptic femoral and tibial non-unions.
• The technique demonstrates predictable healing, excellent functional recovery, and is mechanically sound and efficient.
• This approach represents a reliable first-choice option for managing challenging non-union cases.