A novel bone graft technique combined with plating for aseptic recalcitrant long bone nonunion

Abstract

BackgroundFracture nonunion sometimes occurs after treatment, and some patients are still difficult to heal after many times of treatment. In order to more effectively treat nonunion and heal patients with recalcitrant nonunion, a new technique for autogenous iliac crest bone grafting combined with locking compression plate(LCP) vertical fixation is presented.This study retrospectively analyzed the data of patients with recalcitrant long bone nonunion treated in our hospital to investigate the effect of this technique .MethodsFrom July 2010 to September 2020,34 patients with recalcitrant long bone nonunion underwent surgical treatment and completed follow-up at Xi’an Hong Hui Hospital.Follow-up was for at least 12 months after intervention.The injury mechanism,nonunion type,the duration of nonunion,prior treatments and the outcomes following surgery were recorded for all patients.ResultsThis study enrolled 34 patients(24 males and 10 females), with a mean age of 49.8 ± 12.3years. There were 3 patients with ulnar nonunion,1 patients with ulna and radius nonunion,9 patients with humeral shaft nonunion,1 patient with proximal humerus,2 patient with supracondylar humeru nonunion,10 patient with femoral shaft nonunion, 1 patient with supracondylar femoral nonunion,1 patient with tibiofibular nonunion,5 patient with tibia nonunion and 1 patient with clavicular nonunion.All patients received more than one regular treatment.32 patients union after 6.8 ± 2.4 months, and 2 patients had still nonunion with implants intact.ConclusionBone-forming channel technique combined with LCP vertical fixation is an excellent option for the treatment of recalcitrant long bone nonunion.Level of evidenceTherapeutic Level IV.