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Double-plate fixation together with bridging bone grafting in nonunion of femoral supracondylar, subtrochanteric, and shaft fractures is an effective technique

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Abstract

Purpose

The aims of the present study were to evaluate and report the therapeutic outcomes of double-plate fixation in combination with autogenous bridging bone grafting in treatment of nonunion fractures of femur.

Methods

In this retrospective case series study, 41 patients with nonunion fracture of femur who underwent surgery by double-plate fixation and autogenous bridging bone grafting in academic referral center from July 2010 to July 2015 were enrolled. Totally, 32 males and 9 females with mean age of 35 years were evaluated. They were evaluated for related risk factors, previous therapeutic methods, time interval between injury to nonunion surgery and surgery to full clinical and radiological union, duration of follow-up, levels of postoperative limb shortening, and movement limitations.

Results

Ten patients had open fractures and eight patients had infected nonunion in the femoral supracondylar, subtrochanteric, and shaft fractures. Nailing was the most common used method as the primary treatment of femoral shaft fractures. In addition, the mean follow-up time was 37 months. Full union was obtained even in infected cases. Deep vein thrombosis was found in one patient and pulmonary thromboembolism in another patient, and both patients were treated successfully. Moreover, limitations of articular movements were seen in seven patients.

Conclusion

Double-plate fixation in combination with bridging bone grafting is an effective method in the treatment of nonunion of femoral supracondylar, subtrochanteric, and shaft fractures even in the infected cases.

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Authors and Affiliations

  1. Ghaem Clinical Research Development Unit, Guilan University of Medical Sciences, Rasht, Iran

    Mohsen Mardani-Kivi

  2. Orthopedic Department, Kerman University of Medical Sciences, Kerman, Iran

    Mahmoud Karimi Mobarakeh

  3. Orthopedic Department, Akhtar Hospital, Shahid-Beheshti University of Medical Sciences, Tehran, Iran

    Sohrab Keyhani

  4. Orthopedic Research Center, Guilan University of Medical Sciences, Rasht, Iran

    Zoleikha Azari

  5. Orthopedic Department, Poursina Hospital, Guilan University of Medical Sciences, Parastar Ave., Rasht, 4137816375, Iran

    Zoleikha Azari

Authors
  1. Mohsen Mardani-Kivi
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  2. Mahmoud Karimi Mobarakeh
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  3. Sohrab Keyhani
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  4. Zoleikha Azari
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Correspondence to Zoleikha Azari.

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Mardani-Kivi, M., Karimi Mobarakeh, M., Keyhani, S. et al. Double-plate fixation together with bridging bone grafting in nonunion of femoral supracondylar, subtrochanteric, and shaft fractures is an effective technique. Musculoskelet Surg 104, 215–226 (2020). https://doi.org/10.1007/s12306-019-00615-0

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  • DOI: https://doi.org/10.1007/s12306-019-00615-0

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