Reamed intramedullary exchange nailing: treatment of choice of aseptic femoral shaft nonunionReportar como inadecuado

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Journal of Orthopaedic Surgery and Research

, 9:88

First Online: 10 October 2014Received: 26 March 2014Accepted: 17 September 2014


BackgroundThe aim of this study was to evaluate a standardized method of treatment of femoral nonunion of the isthmal femur excluding non-united metaphyseal fractures.

MethodsBetween 2003 and 2010, 72 consecutive patients with nonunion of the femoral shaft were operated using a standardized protocol in our trauma department and followed up for successful union and functional result.

ResultsOsseous healing was observed in 71 patients 98%. Only one patient was lacking bone healing following a time period of 24 months after the first exchange nailing and 5 months after the second exchange nailing. In 59 patients 82%, uneventful and timely bone healing after exchange nailing was detected. In 18% of patients n = 13, delayed bone healing was observed and required additional therapy. In the majority of patients 61%, bone healing occurred within the first 2 to 5 months, only 18% of patients- duration of bone healing exceeded 8 months. In 62 patients 86%, no relevant or clinically apparent leg-length discrepancy prior to and after exchange nailing was detected as well as no significant axis deviation or malrotation. Functional studies including simple clinical gait and standing analysis, return to activities of daily life, return to sports activities, and return to work were all reached on a satisfying level.

DiscussionReamed intramedullary exchange nailing as described in this study is the treatment of choice for aseptic femoral shaft nonunion with a high rate of bone healing and a low rate of complications including length discrepancy or malrotation and a good functional outcome.

KeywordsFemoral nonunion Exchange nailing Reamed intramedullary nailing Electronic supplementary materialThe online version of this article doi:10.1186-s13018-014-0088-1 contains supplementary material, which is available to authorized users.

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Autor: Christian Hierholzer - Claudio Glowalla - Michael Herrler - Christian von Rüden - Sven Hungerer - Volker Bühren - Jan Fri


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