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KMID : 0361620070420050653
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Journal of the Korean Orthopaedic Association
2007 Volume.42 No. 5 p.653 ~ p.658
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Treatment of the Femoral Shaft Nonunion Occurred after Intramedullary Nailing
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Jung Heun-Guyn
Kim Dae-Joong
Kim Byung-Hak
Chung Young-Yool
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Abstract
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Purpose: To evaluate of efficacy of the treatment options for a femoral shaft nonunion occurring after intramedullary nailing.
Material and Methods: Thirty-one patients with nonunion of a femoral shaft fracture, who had been treated with interlocking intramedullary nailing from January 1996 to December 2000, were examined. Twenty-six had oligotrophic nonunion and five were hypervascular. Forty-five procedures were performed for 31 nonunions; bone grafting for 14, exchange nailing for 13, plate augmentation and bone grafting for 14 and dynamization for 4 cases.
Results: The success rate after a single procedure was only 58%. The four dynamization cases failed to unite. Seven of the 13 (54%) nonunion cases treated with nail exchange healed satisfactorily. All cases treated with plate augmentation and bone grafting achieved successful union. The mean period from fracture to union was 20 months.
Conclusion: Exchange nailing is not always a reliable procedure for treating nonunion of a femoral shaft fracture. Plate augmentation and bone grafting were found to be a successful mode of therapy for the femoral shaft nonunion without complications.
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KEYWORD
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Femur, NONUNION, INTRAMEDULLARY nailing, Exchange nailing, Plate augmentation
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