J Korean Fract Soc.  2011 Oct;24(4):313-320.

Analysis of Risk Factors for Nonunion after Intramedullary Nailing of Femoral Shaft Fracture in Adult

• Shin YW
• Sung YB
• Choi JY
• Kim M

Abstract

PURPOSE
To evaluate the union time and nonunion rate after intramedullary nailing of femoral shaft fracture in adult, we would like to analysis the operation techniques, comminution, contact surface and displacement.
MATERIALS AND METHODS
We reviewed retrospectively 53 patients undergoing femoral intramedullary nailing at least 2 years postoperatively and analysised the union time and nonunion rate by operation techniques, comminution, contact surface and displacement. Patients were operated by either antegrade or retrograde intramedullary nailing.
RESULTS
There were no differences in nonunion rate, the duration of bony union between antegrade and retrograde intramedullary nail groups. Significant differences were found in the duration of bony union between the Winquist and Hansen type I, II and the type III, IV (p<0.05). There were significant differences in the duration of bony union among simple, comminuted, and segmental fracture groups (p<0.05).
CONCLUSION
The union time is affected by not operation techniques and fracture displacement, but Winquist-Hansen classification and number of fracture fragments in intramedullary nailing of adult femoral shaft fracture.

Keyword

Femoral shaft fracture; Union time; Nonunion rate; Intramedullary nailing

MeSH Terms

Adult
Displacement (Psychology)
Fracture Fixation, Intramedullary
Humans
Nails
Retrospective Studies
Risk Factors

Figure

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  Fig. 1 23 year-old female who sustained right femoral shaft fracture was treated by retrograde intramedullary nailing.

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  Fig. 2 67 year-old female who sustained left femoral shaft fracture was treated by antegrade intramedullary nailing.

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  Fig. 3 Graph showing duration of bony union according to type of Winquist and Hansen classification. Significant differences were found in the duration of bony union between the Winquist and Hansen type I, II and the type III, IV.

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  Fig. 4 Graph showing duration of bony union according to the number of Fracture fragments. There were significant differences in the duration of bony union both between the simple and comminuted fracture groups, simple and segmental fracture.

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