Clinical efficacy of double steel plates combined with bone grafting in treatment of aseptic nonunion after surgery for adult femoral shaft fracture

Objective To investigate the clinical efficacy of double steel plates combined with autogenous iliac bone grafting in treatment of aseptic nonunion after surgery for adult femoral shaft fracture. Methods A retrospective study was conducted to analyze the clinical data of 35 adult patients with aseptic nonunion after surgery for femoral shaft fracture admitted to the First Affiliated Hospital of Zhengzhou University from January 2017 to June 2018. There were 28 males and 7 females, aged 18 to 63 years. Twenty-one cases had been treated with plate fixation, and fourteen cases with intramedu-llary nail after fracture.Patients with intramedullary nail needed to remove the original internal fixation. While for patients with steel plate fixation, the original internal fixation could be removed or preserved in accordance with specific conditions. All patients were treated by double locking compression plates (LCP) combined with autogenous iliac bone grafting. The operation time, intraoperative blood loss, complications and fracture healing time were recorded.The outcomes were evaluated according to the hospital for special surgery (HSS) knee score. Results The operation time was 95 to 140 minutes, the intraoperative blood loss was 100 to 200 ml. There were 3 cases with the original internal fixation. All patients were followed up for 6-12 months. All patients healed after operation, and the time of fracture healing was 4-9 months. No breakage or loosening, internal fixation, incision infection, incision disunion, refracture occured during follow-up. The HSS knee score (86.77±8.41) and the excellent and good rate (91.43%)were improved, compared with pre-operative values (51.26±10.79, 5.71%). Conclusions Double steel plates combined with autogenous iliac bone grafting is a relatively ideal method to treat aseptic nonunion after surgery for adult femoral shaft fracture, which has high rate of fracture union and few complications. Key words: Femoral shaft fracture; Bone grafting; Locking compression plate, double steel plates; Aseptic nonunion