Retrograde locked intramedullary nailing for aseptic supracondylar femoral nonunion following failed locked plating.

Abstract:

PURPOSE:To review the outcome of retrograde locked nailing for aseptic supracondylar femoral nonunions following failed locked plating. METHODS:Records of 20 men and 4 women aged 20 to 57 (mean, 39) years who underwent retrograde locked intramedullary nailing for aseptic supracondylar femoral nonunion following failed locked plating were reviewed. There were 20 closed and 4 open Gustilo type II or IIIA fractures secondary to motor vehicle accidents (n=21) or falls (n=3). Patients had undergone one to 3 operations. The mean time from injury to the present revision surgery was 1.3 years. No patient had a flexion contracture. The locked plate was removed and replaced with a retrograde dynamic locked nail (with or without buttress plate augmentation) followed by bone grafting. RESULTS:17 men and 4 women were followed up for a mean of 3.4 years. The rest were lost to follow-up. The 21 patients achieved bone union after a mean of 4.3 months. The mean maximal knee flexion improved from 97.1º to 107.6º (p=0.03). Knee function was excellent in one, good in 15, and fair in 5 knees. The fair outcome was due to extension contracture, varus knee deformity, or knee pain. There were 3 malunions with varus deformity of 7º, 8º, and 9º each. No patient had deep infection causing a nonunion. All 21 patients could walk without aids. CONCLUSION:Retrograde locked intramedullary nailing for aseptic supracondylar femoral nonunions following failed locked plating achieved a high union rate.

authors

Wu CC

doi

10.1177/230949901502300207

subject

Has Abstract

pub_date

2015-08-01 00:00:00

pages

155-9

issue

2

eissn

1022-5536

issn

2309-4990

journal_volume

23

pub_type

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