Evaluating the Effect of Double Plating Fixation with Bone Graft in Nonunion of Femoral and Tibial Fractures after Primary Surgery

Babak Siavashi; Mohammad Rastegar; Yousof Fallah; Ehsan Pendar; Mohammad Soleimani; Seyyed Hossein Shafiei

doi:10.18502/jost.v8i2.9310

Babak Siavashi Associate Professor, Orthopedic Surgery Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
Mohammad Rastegar Orthopedic Assistant, Orthopedic Surgery Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
Yousof Fallah Assistant Professor, Orthopedic Surgery Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
Ehsan Pendar Assistant Professor, Orthopedic Surgery Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
Mohammad Soleimani Orthopedic Assistant, Orthopedic Surgery Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
Seyyed Hossein Shafiei Assistant Professor, Orthopedic Surgery Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/jost.v8i2.9310

Keywords: Femoral Fractures; Tibial Fractures; Ununited Fractures

Abstract

Background: Several treatment approaches are now considered to manage tibial and femoral shaft nonunion after primary surgeries. Double-locking plates with channel bone grafting technology are treatments that surgeons could choose. We aimed to describe our experiences in evaluating the union of bone for these patients after using double-locking plates with channel bone grafting with serial examinations and radiologic studies.

Methods: This case study was conducted on 33 patients consisting of 20 femoral nonunion and 13 tibial nonunion cases. They underwent double plate fixation with bone grafting at Sina Hospital, Tehran, Iran, from 2015 to 2020. They were monitored for an average of 60 months after surgery

Results: Union was achieved in all the patients in a mean of 10.03 months (range: 8-18 months). During patients’ follow-up, no plate and screw breakage, device loosening, deformity, and infection were seen. No additional surgery was needed for any of our patients.

Conclusion: There are various treatment options for nonunion of long bones. This study described the double plating approach for treating femoral and tibial shaft nonunion. The technique of double plate fixation and bone grafting had reasonable union rates in long bone nonunion. The present case series analysis also shows that it is more beneficial to manipulate this promising method for long bone nonunion whenever possible.