Surgical Management of aseptic Femoral Shaft Non-union after Intramedullary Fixation
Journal Title: The Egyptian Journal of Hospital Medicine - Year 2018, Vol 72, Issue 7
Abstract
<strong>Background:</strong> Several treatment modalities are available for handling of femoral nonunion after intramedullary nailing. These alternatives include nail dynamisation, external fixation, exchange nailing and Plate osteosynthesis. This treatment can be used as augmentation technique over a previous used intramedullary nail, with or without bone grafting. <strong>Objective:</strong> To evaluate the outcome of femoral nonunion after intramedullary fixation by locked nail and management of 30 cases of aseptic femoral nonunion with nail exchange or augmentation with plate. <strong>Patients and Methods:</strong> We reviewed 30 patients with femoral fracture nonunion after interlocking intramedullary nailing treated either with exchange nailing with or without bone graft or plate augmentation and bone grafting with the nail in situ. The mean time from primary nailing to exchange nailing or plate augmentation and bone grafting was 9.80±5.45 months for achieving stability of the fracture. We did exchange nailing with larger diameter nail or applying DCP plate on the lateral aspect of the femur. <strong>Results:</strong> 27 patients achieved solid union in time ranged from 6-12 months with mean of 7.54±2.18. <strong>Conclusion:</strong> Exchange reamed intramedullary nailing has low morbidity, may obviate the need for additional bone grafting, and allows full weight-bearing and active rehabilitation provides extremely rigid fixation, and provides reason to allow patients to bear weight early in the postoperative period. Bone graft could be precisely placed in the fracture site if necessary.
Authors and Affiliations
Eman Helal
Keywords
Related Articles
- EP ID EP584265
- DOI 10.12816/ejhm.2018.10178
- Views 117
- Downloads 0
Dinoprostone Versus Misoprostol for Cervical Ripening before Diagnostic Hysteroscopy in Nulliparous Women: A Randomized Controlled Trial
<strong>Background: </strong>Hysteroscopy has revolutionized the field of Gynecology and the management of many gynecological conditions. It has now become a standard part in the diagnosis of postmenopausal bleeding by t...
Comparative Study between Myoring and Ferrara Ring Intracorneal Implantation Using Femtosecond Laser for Treatment of Keratoconus
Background: Keratoconus is a bilateral progressive, non-inflammatory ectatic corneal disease characterized by changes in corneal collagen structure and organization. Though the etiology remains unknown, novel techniques...
The Use of Levonorgestrel-Releasing System (Metraplant-E) in the Treatment of Abnormal Uterine Bleeding
<span>Background: </span><span>Dysfunctional uterine bleeding (DUB) is one of the commonest condition for which patient seeks out medical consultation. The prevalence increases with the increase of age peaking before men...
Case Report of Ocular Ischemic Syndrome, Taif, Saudi Arabia
<strong>Background: </strong>Ocular ischemic syndrome (OIS) is more prevalent among male aged more than 50 years. Various disorders such as diabetes, hypertension, and peripheral vascular diseases are major risk factors...
Evaluation of Choroidal Changes During Pregnancy
Background: During pregnancy, various physiological changes occur in almost all organs of the body including the eyes. Increased blood volume and cardiac output results in ocular blood flow increase. Consequently, the ch...