[Role of intramedullary nailing in pseudarthrosis and malalignment]

Intramedullary stabilization can provide fast bone consolidation in cases of delayed fracture healing and hypertrophic non-unions. The indication for intramedullary nailing must be exactly adapted to the individual situation. An analysis of our own cases revealed bony healing in hypertrophic non-unions of femoral shaft fractures in 93% and in 94% of tibial shaft fractures after reamed intramedullary nailing. In selected cases of axial or rotational deformities or length discrepancy of the femur and the tibia, a correction osteotomy can be performed with intramedullary nailing. If it is necessary to expose the non-union and in axial or rotational deformities a rotation-stabilizing plate can be applied in addition to the intramedullary nail.