Successful management of atrophic nonunion of a severely osteoporotic femoral shaft in a child

We present a case illustrating the successful use of a conventional intramedullary rod and vascularized iliac crest graft in atrophic nonunion combined with severe osteoporosis of the femoral shaft in a child, in whom classical osteosynthesis failed after two operations. The conventional intramedullary rod offered excellent purchase in the severely porotic, partially destroyed bone. Combined with a vascularized iliac crest grafted laterally, mechanical support and an osteoinductive stimulus were provided. The atrophic nonunion healed completely after this revision surgery.