Is the Wave Plate Still a Salvage Procedure for Femoral Non-union? Results of 75 Cases Treated with a Locked Wave Plate.

OBJECTIVE

To analyse the results of the treatment of aseptic femoral non-unions using a singular locked implant.

DESIGN

Consecutive case series.

SETTING

A level-1 trauma center with a high number of specialist referrals.

PATIENTS

The study is based on a consecutive series of patients with prospective data evaluation. From 1993 to 2003, 75 patients were treated with a wave plate. All patients had persistent non-union of the femoral shaft without clinical or laboratory signs of infection and previous unsuccessful attempts to treat the non-union.

INTERVENTION

The method of treatment was standardized and included a lateral approach, cancellous bone hip grafting, osteosynthesis with a wave-shaped plate (PPF) and polyaxial locking screws as well as the application of a gentamicin-PMMA chain.

MAIN OUTCOME MEASUREMENTS

Time to achieve union, rate of implant failure and number of remaining nonunions after treatment. A total of 75 patients had full follow-up and were included in the study.

RESULTS

The union of the fracture was found in 64 patients after the initial procedure. In eight cases a second procedure was performed to achieve union in the form of a second bone graft because of a delay in callus formation. The mean time to union was 7.3 months with a range from 3 to 19 months. The implant failed in three cases accounting for 4% of the total.

CONCLUSION

The locked wave plate offers a further reliable treatment for complex aseptic femoral non-unions.