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KMID : 0386420070200020141
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Journal of the Korean Fracture Society
2007 Volume.20 No. 2 p.141 ~ p.148
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Cause and Treatment of the Nonunion of Femoral Shaft Fracture after Interlocking Intramedullary Nailing
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Kim Sung-Soo
Sohn Sung-Keun
Kim Chul-Hong
Lee Myung-Jin
Wang Lih
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Abstract
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Purpose: To analyze the causes and the clinical results of treatm ent for the nonunion of fem ur shaft fractures that occurred after interlocking intram edullary nail fixation.
Materials and methods: W e reviewed 19 cases of aseptic nonunion of fem ur shaft fracture in 174 patients after interlocking IM nailing from M arch 1999 to February 2004 and follow ed up for m ore than one year. First we investigated the factors causing nonunion. For operative options, tw o m ethods about exchange nailing and exchange nailing w ith bone graft w ere perform ed. Finally clinical results w ere analyzed with bone union rate by treatm ent m ethods and com pared with the nonunion factors statistically.
Results: According to the causes and types of nonunion, we perform ed larger IM nailchange in 10 cases and IM nailchange with bone graft in 9 cases. Bone union was achieved in all cases. Average bone union period were 18.5 weeks in exchange group and 16.1 weeks in exchange with bone graftgroup.There are significantdifference between treatm entm ethods statistically (p＜0.05). Com pared w ith the nonunion factors, initial open fracture and sm oking groups show ed late union rate statistically.
Conclusion: Based on our analysis, IM nail change is a useful m ethod for nonunion after initial IM nailing in fem oral shaft fracture, and additional bone graft that according to the radiologic pattern and stability, especially the fracture gap is also a useful option for nonunion treatm ent.
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KEYWORD
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Femur shaft fracture, Nonunion, Interlocking intram edullary nail, Smoking
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