Sliding bone graft combined with double locking plate fixation for the treatment of femoral shaft nonunion

Abstract

Objectives The aim of this study was to describe and evaluate a novel method of sliding bone graft combined with double locking plate fixation in treating femoral shaft nonunion. Methods Clinical data from patients with femoral shaft nonunion that was treated with sliding bone grafts combined with double locking plate fixation were retrospectively collected. Data included duration of surgery, blood loss, union rate, time to union and possible complications. Results Twenty-five patients included in the study were followed for a mean duration of 16.6 ± 2.6 months (range, 12–22 months). All of the fractures (100%) achieved bony union. Mean time to union was 6.0 ± 1.0 months (range, 4–8 months). No infections or medullary cavity occlusions were observed. Conclusions Sliding bone graft combined with double locking plate fixation was shown to be a safe, effective, and convenient surgical option for the treatment of nonunion, due to its high union rates with no complications. Further studies with larger sample sizes and longer-term follow-up are warranted.

Operative treatment of nonunions in the elderly: Clinical and radiographic outcomes in patients at minimum 75 years of age

“…We compared our current results with literature on younger femur and humerus nonunion groups (Table 4 ) [ 20 , 23 , 37 – 63 ]. This table provides a comparative framework (Fig.…”

The efficacy of augmentative anti-rotational plating plus decortication and autogenic bone grafting for aseptic nonunion after intramedullary nailing of femoral shaft fracture

“…[27] At present, the most common bone graft materials are autogenous bone graft (iliac bone, reamed bone) and allogeneic bone graft (BMP-2, allogeneic bone, recombinant human osteogenic protein-1, BMP-7). Based on extensive literature review [10,14,24,28] and the biological perspective, autogenous bone graft is the "gold standard" for the treatment of atrophic nonunion. Autogenous bone has osteogenic activity, good osteoinduction, and good bone conduction.…”

“…Further, nonunion presents a treatment dilemma for surgeons; reasons for nonunion are complex and multiple factors are involved [8] . The main reasons for aseptic nonunion are inadequate fracture stability, insufficient blood supply, and bone loss [9,10] . Consequently, the effective management of nonunion of femoral shaft fractures has become a hot topic.…”

Method of Forensic Assessment of Risk Factors of Treatment Failure Outcomes as an Element of Quality Management of Medical Care

“…The most common cause of complications of submersible osteosynthesis of fractures of long tubular bones is a violation of the technology of internal fixation of bone fragments [31][32][33]. The first step to successful consolidation of the fracture is an open reduction with the restoration of the anatomical relationship in the damaged bone [31,34,35]; in the process of open reduction, it is necessary to avoid extensive skeletalization of fragments [36,37], which allows to save the maximum possible vascularization of the fracture zone. Important aspects of the prevention of complications are preoperative planning with indications for the method of internal fixation, the correct operation with the optimal use of fixing structures [38], long and short screws depending on the fracture type (comminuted, non-fragmented) and fracture location [39,40], an early active development of movements in adjacent joints and a dosed load on the operated limb.…”