alexa Percutaneous Locked Augmentative Plating And Bone Grafting For Treating Aseptic Femoral Nonunion After Intra-medullary Nailing
ISSN: 2161-0533

Orthopedic & Muscular System: Current Research
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10th Global Orthopedicians Annual Meeting
July 03-04, 2017 Kuala Lumpur, Malaysia

Mohamed Ali and Hesham Alaa
Minia University, Egypt
Posters & Accepted Abstracts: Orthop Muscular Syst
DOI: 10.4172/2161-0533-C1-033
Abstract
Introduction: Treatment of femoral shaft non-union after intramedullary nailing (IMN) is controversial. Leaving the nail in situ plus open augmentation plating (AP) and autologous bone grafting remains a popular choice. As open plating has its own complications, the purpose of this study was to evaluate the effectiveness of percutaneous locked augmentation plate (PLAP) plus percutaneous bone grafting (PBG) with leaving the IM nail in situ for treating these cases. Methods: After approval of the local ethical committee, 40 patients, 26 men and 14 women, accepted to participate in this study. Their mean age was 29.5 years (range, 18-58 years). Twenty-four cases (60%) had primary nonunion and 16 (40%) had persistent nonunion after dynamization (n=8), bone grafting (n=5), and exchange nailing (n=3). The outcome measures included time since the primary procedure, number of procedures before our interference, operation time, blood loss, time to union, union rate, and complications. Results: All the patients achieved bony union without the need for secondary procedures except one (97.5%). The mean time for radiological union was 18.2 weeks (range 12–24 weeks). All the patients were satisfied with absence of pain and morbidity (physical and cosmetic). No significant complications such as implant failure, nonunion, or deep infections were encountered. Conclusions: The advantages of open AP could be achieved and the disadvantages could be avoided with PLAP plus PBG. This simple procedure creates minimal damage, increases rotation stability, and facilitates early functional recovery. A comparative study with the open technique is recommended.
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