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Failed intramedullary nailing of femur: open reduction and plate augmentation with the nail in situ

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Fourteen patients with aseptic fractures that failed to unite after intramedullary nailing (IMN) of the femur were treated by augmentation of fixation by dynamic compression plate (DCP) with the nail in situ. In six of them that had axial or rotational malalignment, direct reduction of the bone fragments and plating were done. Iliac bone grafting was performed in nine cases, when there were gaps between the fragments and in atrophic non-unions. Patients were followed-up for an average of 26 months.


All patients had radiological union in an average of 4.3 months with an improvement in alignment, range of motion and shortening.


For failed IMN of the femur, augmentation of fixation by compression plate, with the nail in situ, is a good line of treatment. In cases with malalignment, correction was possible followed by plate augmentation.

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Correspondence to Galal Zaki Said.

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Said, G.Z., Said, H.G. & El-Sharkawi, M.M. Failed intramedullary nailing of femur: open reduction and plate augmentation with the nail in situ. International Orthopaedics (SICOT) 35, 1089–1092 (2011).

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