Interlocking intramedullary nail for the treatment of femoral nonunion

Objective:To analyze the causes of femoral nonunion,and to investigate clinical effects of interlocking intramedullary nails for the treatment of femoral nonunion. Methods:From January 2001 to January 2009,31 patients with femoral nonunion were treated with interlocking intramedullary nail. Among the patients,19 patients were male and 12 patients were female,ranging in age from 18 to 73 years,with an average of 32.5 years. Twenty-four patients had nonunion of femoral shaft,and 7 patients had nonunion at the distal femur. The patients with nonunion of femoral shaft were treated with normal interlocking intramedullary nails and the patients with nonunion at the distal femur were treated with supracondylar femur interlocking nails. The reamed technique was used in all patients. All the patients were treated with internal fixation with interlocking intramedullary nails and autogenous bone transplantation. Results:All the patients were followed up,and the duration ranged from 14 to 72 months,with a mean of 23 months. Thirty patients got bony union,and an average healing time was 4.6 months (3 to 6 months). Another patient healed after bone re-transplantation and intramedullary nail fixation. All the hip joints recovered to normal function. The average HSS knee score was 89.97±5.21 at 1 year after operation. Conclusion:The use of interlocking intramedullary nail for the treatment of femoral nonunion has follow advantages:reliable fixation,good stability,in favor of early functional exercise of extremities and joints. Reaming combined with autologous bone graft may be good treatment methods.