Retrograde Locked Intramedullary Nailing for Aseptic Supracondylar Femoral Nonunion following Failed Locked Plating

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 nonu...

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Main Author: Chi-Chuan Wu
Format: Article
Language:English
Published: SAGE Publishing 2015-08-01
Series:Journal of Orthopaedic Surgery
Online Access:https://doi.org/10.1177/230949901502300207
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spelling doaj-c18e312bba7148d49d1e6ef7d0d04e5e2020-11-25T03:43:55ZengSAGE PublishingJournal of Orthopaedic Surgery2309-49902015-08-012310.1177/230949901502300207Retrograde Locked Intramedullary Nailing for Aseptic Supracondylar Femoral Nonunion following Failed Locked PlatingChi-Chuan WuPurpose. 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 97.1° to 107.6° (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 7°, 8°, and 9° 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.https://doi.org/10.1177/230949901502300207
collection DOAJ
language English
format Article
sources DOAJ
author Chi-Chuan Wu
spellingShingle Chi-Chuan Wu
Retrograde Locked Intramedullary Nailing for Aseptic Supracondylar Femoral Nonunion following Failed Locked Plating
Journal of Orthopaedic Surgery
author_facet Chi-Chuan Wu
author_sort Chi-Chuan Wu
title Retrograde Locked Intramedullary Nailing for Aseptic Supracondylar Femoral Nonunion following Failed Locked Plating
title_short Retrograde Locked Intramedullary Nailing for Aseptic Supracondylar Femoral Nonunion following Failed Locked Plating
title_full Retrograde Locked Intramedullary Nailing for Aseptic Supracondylar Femoral Nonunion following Failed Locked Plating
title_fullStr Retrograde Locked Intramedullary Nailing for Aseptic Supracondylar Femoral Nonunion following Failed Locked Plating
title_full_unstemmed Retrograde Locked Intramedullary Nailing for Aseptic Supracondylar Femoral Nonunion following Failed Locked Plating
title_sort retrograde locked intramedullary nailing for aseptic supracondylar femoral nonunion following failed locked plating
publisher SAGE Publishing
series Journal of Orthopaedic Surgery
issn 2309-4990
publishDate 2015-08-01
description 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 97.1° to 107.6° (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 7°, 8°, and 9° 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.
url https://doi.org/10.1177/230949901502300207
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