Evaluation of Treatment Outcomes for Femoral Shaft Nonunion Fixed with Intramedullary Nail, with Addition of Plate and Bone Graft

Document Type : Original Article

Authors

1 Department of Surgery, School of Medicine, Fatemi Hospital, Ardabil University of Medical Sciences, Ardabil, Iran.

2 Department of Community Medicine, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran.

10.22038/psj.2025.91761.1496

Abstract

Introduction:
Femoral shaft nonunion is a serious and challenging complication following intramedullary nailing requiring effective interventions to achieve successful bone union.

Materials and Methods:
In this retrospective cross-sectional study, 20 patients with femoral shaft nonunion previously treated with intramedullary nailing underwent revision surgery with augmentation plating and bone grafting.
Results:
The mean age of patients was 42.5 years, and 90% achieved complete bone union. The average union time was 16.2 weeks. Factors influencing outcomes included age, underlying diseases, fracture type, and the time to revision surgery. Compared to a historical control group treated with revision nailing alone, this study showed significantly reduced healing time and improved function. Limited complications included superficial infections managed conservatively.
Conclusion:
The findings highlight augmentation plating and bone grafting as an effective and reliable approach for treating femoral shaft nonunion after intramedullary nailing. Future prospective studies with larger samples and long-term follow-up are recommended to assess treatment durability and possible complications. Additionally, investigating factors affecting recovery and quality of life could improve treatment protocols.

Keywords

Main Subjects

References

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Journal of Patient Safety & Quality Improvement
Volume 14, Issue 1
January 2026
Pages 27-33

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