الفهرس | Only 14 pages are availabe for public view |
Abstract Intramedullary nailing has been the method of choice for most acute femoral shaft fractures in adult; however complication rate such as infection, shorting and nonunion has increased. Despite the advances in trauma care, nonunion still occur. Nonunion is defined as fractured bone that has not shown progression toward healing over 6 consecutive months on serial radiographs , many authors suggest that optimum time for healing is from 4 to 12 months depends on the bone in question, the location of fracture , the nature of the injury and quality of soft tissue. There are four main causes of nonunion: motion, avascularity, stripping, fracture gap, and infection. Nonunion are classically categorized as hypertrophic, normotrophic, and atrophic. Hypertrophic presents radiologically with abundant callus and persistent radiolucent line at the fracture site while a normotrophic non-union has minimal callus but relatively normal bone ends with no resorption, atrophic is characterized by absence of callus resorption of boneresorption, atrophic is characterized by absence of callus resorption of bone ends and significant fracture gap. Although various methods including exchanging a nail, dynamization, plate augmentation and autogenous bone grafting have been introduced for the treatment of aseptic nonunion, there is no universally accepted approach or algorithm to assess and treat the aseptic nonunion of the femur after intramedullary nailing. So in this study we aim to assess the results of revision of aseptic non united femoral shaft fractures previously fixed with inter-locking femoral nail by anatomical intra medullary nail. |