EXCHANGE NAILING FOR NON-UNION OF FEMORAL SHAFT FRACTURES
Abstract
Background: There are many ways to treat aseptic non-union of femoral shaft fractures with reportedvaried success rate. Amongst all these, Exchange nailing is the simplest and most successful techniquefor treating aseptic non union of femoral shaft fractures. We have carried out a prospective study in theDepartment of Trauma & Orthopaedics, Ayub Medical College Abbottabad to analyse the role ofexchange nailing for aseptic non union of femoral shaft fractures. Methods: Forty-three femoral shaftaseptic non-unions in 41 consecutive patients were treated using exchange IM nailing, from January2006 to December 2007. The inclusion criteria for patients in the study was a femoral shaft fractures’aseptic non-union, has less than 1 Cm shortening with no segmental bone defect, and a radiolucent lineof the non-union, and which had previously been treated by intra-medullary nail. The surgical techniqueincluded removal of previously inserted intra-medullary nail, reaming of medullary cavity up to 2 mmabove the previous size, and re-insertion of statically locked exchange intra-medullary nail. Results:Forty-three femoral shaft aseptic non-union in 41 patients were treated; the mean age of the patientswas 38.81±13.75 years. Thirty-nine non-union out of total 43 cases (39/43) had healed giving a unionrate of 90%. Non-union persisted in the remaining four cases (4/43) in-spite of extended post operativefollow up of these patients for 18 months. Mean union was 4.97±1.53 months. No major surgicalcomplications were noted. Conclusion: Exchange nailing is a simple technique for treating aseptic nonunion of femoral shaft fractures. Based on the results of our study, we recommend it as the procedure ofchoice for non comminuted, aseptic non union of femoral shaft fracture.Keywords: Aseptic non-union, femoral non-union, exchange interlocking intra-medullary nailingReferences
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