[Interlock plate fixation for the treatment of femoral hypertrophic nonunions after intramedullary nailing fixation].

OBJECTIVE

To investigate clinical effect of locking plate assisted intramedullary nail in treating femoral hypertrophic nonunions after intramedullary fixation.

METHODS

From January 2006 to December 2015, clinical data of 40 patients with femoral nonunions after intramedullary nail internal fixation treated with interlock plate internal fixation were respectively analyzed. Among patients, there were 22 males and 18 females, aged from 21 to 60 years old with an average age of (35.0±2.2) years. The time of bone nonunion ranged from 9 to 24 months with an average of (14.1±1.5) months. Operative time, blood loss, hospital stay , complications, bone healing time and recovery of function were observed, Evanich scoring was applied to evaluate clinical effects.

RESULTS

All patients were followed up from 12 to 24 months with an average of (15.2±2.7) months. Operative time ranged from 105.1 to 130.2 min with an average of (112.5±10.2) min;blood loss ranged from 207.0 to 250.2 ml with an average of (220.6±14.7)ml; hospital stay ranged from 10 to 15 days with an average of (12.2±1.5) d. All patients were obtained bone healing from 4 to 12 months after additional plate internal fixation, with an average of (6.2±1.9) months. No implant failure and infection occurred after operation. According to Evanich scoring of knee joint, total score was 83.2±5.6, 22 cases obtained excellent results, 17 good and 1 fair.

CONCLUSIONS

Limited incision approach locking plate with original intramedullary nail fixation for femoral hypertrophic nonunions subsequent to intramedullary fixation could receive good results, increase stability of fracture, and could increase stability of fracture, provide environment for callus growth. It had advantages of high cure rate, less trauma and complications, and also could do functional exercise earlier to promote good recovery of knee joint.