Cause Analysis and Related Treatment of Aseptic Nonunions of Femoral Shaft Fractures after Femo-ral Nailing

Abstract：Objective To investigate the causes and treatment of femoral shaft fracture aseptic nonunion and delayed u-nion after interlocking intramedullary nailing. Methods In this study,389 cases from the orthopedic ward of our Hospital since July 2008 to December 2013 of femoral shaft fractures were treated with femoral nailing,31 patients with bone aseptic nonunion and delayed union after interlocking intramedullary nailing for femoral shaft fracture were treated. These patients were retrospectively analyzed. The early treatment methods was dynamization of intramedullary nail. If not yet healing,using pedicled bone cortex peel and autogenous iliac bone graft. The clinical outcomes of the secondary treatment were observed. Results The middle femoral 1/3 femoral shaft was the freQuently site of nonunion. The cause of nonunion was closely related with the o-riginal treatment,fracture type. Early dynamization of intramedullary nail could promote the healing of fracture;for dystrophic fracture nonunion,simple intramedullary nail force after fracture was difficult to heal,method of pedicled bone cortex stripping plus autologous iliac bone graft can promote fracture healing. Conclusion Many factors may contribute to fracture nonunion and delayed union after interlocking intramedullary nail fixation. Clinical outcomes of surgical treatment are good for nonunion and delayed union of femoral shaft fracture.