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Plate augmentation leaving the nail in situ and bone grafting for non-union of femoral shaft fractures

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We reviewed 15 patients with femoral non-union after interlocking intramedullary nailing treated with plate augmentation and bone grafting with the nail in situ. The mean time from primary nailing to plate augmentation and bone grafting was 10 months. At the time of presentation, the patients had undergone an average of 1.6 operations from the time of their original injury. To achieve stability of the fracture, we applied an AO plate on the lateral aspect of the femur. The retained nail maintained alignment of the fracture, and plating did not require an extensive surgical approach. In all patients, there was visible motion at the fracture site; however, the motion disappeared after plate augmentation. All patients achieved radiological solid union at an average of 7.2 months.


Nous avons suivi 15 malades avec une pseudarthrose fémorale après enclouage centromédullaire traitée avec une plaque supplémentaire et une greffe osseuse en laissant le clou en place. Le délai moyen entre l’enclouage initial et la reprise chirurgicale avec plaque et greffe était de 10 mois. Au moment de l’étude les malades avaient subi une moyenne de 1,6 opérations à dater du traumatisme. Pour obtenir la stabilité de la fracture, nous avons utilisé une plaque externe AO. Le clou laissé en place a maintenu l’alignement de la fracture et la mise en place de la plaque n’a pas exigé un abord chirurgical étendu. Chez tous les malades il y avait une mobilité du foyer de fracture qui a disparue après l’ostéosynthèse par la plaque. Tous les malades avaient une consolidation radiologique solide à une moyenne de 7,2 mois.

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Correspondence to Y. S. Choi.

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Choi, Y.S., Kim, K.S. Plate augmentation leaving the nail in situ and bone grafting for non-union of femoral shaft fractures. International Orthopaedics (SICOT) 29, 287–290 (2005).

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