Chipping and lengthening over nailing technique for femoral shaft nonunion with shortening

Int Orthop. 2017 Sep;41(9):1859-1864. doi: 10.1007/s00264-017-3535-x. Epub 2017 Jun 21.

Abstract

Purpose: Chipping and lengthening over nailing (CLON) technique was developed to treat femoral shaft nonunion with shortening more than 10 mm. The purpose of the current retrospective case series was to clarify the effectiveness of the CLON technique on the femoral shaft nonunion following intramedullary nailing.

Methods: Clinical and radiological outcomes in the patients receiving operative treatment for femoral shaft nonunion between August 2012 and December 2016 were retrospectively reviewed using the Refractory Fracture Data Registry at the authors' institution. The CLON technique was indicated for patients with the femoral shaft nonunion with shortening more than 10 mm.

Results: Five patients with median follow-up of 32 months (range, 14 to 50 months) were included in this study. All patients achieved bone union at the median of 8 months after the CLON technique. The median limb length discrepancy was 2.0 mm at the most recent follow-up.

Conclusions: The present study demonstrated that the CLON technique for femoral shaft nonunion may be the first choice as operative treatment for femoral shaft nonunion with shortening more than 10 mm.

Keywords: External fixator; Femoral shaft nonunion; Intramedullary nailing; Operative treatment; Retrospective study.

MeSH terms

  • Adult
  • Bone Lengthening / methods*
  • Diaphyses
  • Femoral Fractures / complications
  • Femoral Fractures / surgery*
  • Femur / injuries
  • Femur / surgery
  • Follow-Up Studies
  • Fracture Fixation, Intramedullary / methods*
  • Fractures, Ununited / surgery*
  • Humans
  • Leg Length Inequality / etiology
  • Leg Length Inequality / surgery*
  • Male
  • Middle Aged
  • Range of Motion, Articular
  • Registries
  • Retrospective Studies
  • Treatment Outcome