Anti-Rotational Plates with Intramedullary Nailing Stabilize Femoral Shaft Fracture Nonunion: A Biomechanical Study

Ma, Xianzhi

doi:10.23937/2378-3397/1410034

Cited by 1 publication

(1 citation statement)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Most aseptic diaphyseal non-unions of the femur are thought to occur due to mechanical instability, predominantly rotational instability [ 24 , 25 ]. Exchange nailing to a larger diameter nail goes some way to improving the biomechanical environment as larger diameter IMNs are torsionally stiffer.…”

Section: Discussionmentioning

confidence: 99%

Uniting the un-united: should established non-unions of femoral shaft fractures initially treated with IM nails be treated by plate augmentation instead of exchange IM nailing? A systematic review

Medlock¹,

Stevenson²,

Johnstone³

2018

Strategies in Trauma and Limb Reconstruction

View full text Add to dashboard Cite

The majority of femoral fractures are surgically treated with intramedullary nails. Non-union rate is low but challenging and costly if it occurs. There have been encouraging results from the use of augmentative plating as a treatment for non-union of femoral fractures. We performed a systematic review of the literature to compare union rates, time to union and complications between exchange nailing and augmentative plating as a primary procedure following a diagnosis of femoral non-union following initial nailing. We found a total of 21 papers, which found the mean union rate of augmentative plating to be 99.8% compared to 74% (P = 2.05−12) found for exchange nailing. Times to union were comparable at 5.9 months for augmentative plating and 6.3 months for exchange nailing (P = 0.68916), and complication rate was 4% for augmentative plating compared to 20% for exchange nailing. From the evidence available, plate augmentation provides a more reliable union rate if used as the first operative intervention on a non-union of a femoral fracture compared to exchange nailing.Level of Evidence IV Systematic review of therapeutic studies.

show abstract

Section: Discussionmentioning

confidence: 99%