Treatment of aseptic diaphyseal nonunion of the lower extremities with exchange intramedullary nailing and blocking screws without open bone graft.

Orthopaedic surgery

PubMedID: 22009873

Gao KD, Huang JH, Li F, Wang QG, Li HQ, Tao J, Wang JD, Wu XM, Wu XF, Zhou ZH, Wang F, Lu HM. Treatment of aseptic diaphyseal nonunion of the lower extremities with exchange intramedullary nailing and blocking screws without open bone graft. Orthop Surg. 2009;1(4):264-8.
OBJECTIVE
To report the preliminary results of the treatment of aseptic diaphyseal nonunion of the lower extremities with exchange nailing plus blocking screws.

METHODS
Between June 2005 and September 2008, twelve patients with diaphyseal nonunion in the lower extremities (femur in five patients and tibia in seven; hypertrophic nonunion in eight patients and atrophic nonunion in four) were treated by reaming, exchanging the original intramedullary nail with a larger one, and using blocking screws, and the therapeutic effect assessed.

RESULTS
All patients were followed up for 1-2 years (average, 1.5 years) to assess union. Bony union was achieved in all patients within 4.7-13.5 months (average, 7.8 months). All patients were pain free without any complications by the last follow-up.

CONCLUSION
The therapeutic method of exchanging the nail combined with blocking screws is effective for aseptic nonunion of the lower extremity after intramedullary nailing.