Ununited fractures of the femur stabilized with the fluted rod.

Sixteen patients with ununited fractures of the femoral shaft were treated by the fluted intramedullary rod. Five cases were considered delayed unions and eleven nonunions. Fourteen fractures were managed by an open technique and two by a closed technique. Three of four cases treated open without a bone graft failed to unite after the initial nailing. These three fractures subsequently united following bone grafting. Two were renailed with a larger rod. Eventually, all 14 fractures united. The fluted rod appears to be an effective device for treating a variety of ununited fractures of the femur. Bone grafting in association with an open technique is advisable and is especially recommended when interposed connective tissue and bone have had to be excised from the fracture site.