TY - JOUR
T1 - Treatment of distal femoral nonunion with internal fixation, cortical allograft struts, and autogenous bone-grafting
AU - Wang, Jun Wen
AU - Weng, Lin Hsiu
PY - 2003/3/1
Y1 - 2003/3/1
N2 - Background: The purpose of this retrospective study was to analyze the results of treatment of nonunions of the distal part of the femur with internal fixation combined with cortical allograft struts and autogenous bone-grafting. Methods: Thirteen patients with a distal femoral nonunion were treated with open reduction and internal fixation combined with deep-frozen cortical allograft struts and autogenous iliac bone grafts. The level of nonunion was infraisthmal in three patients and supracondylar in ten. Ten nonunions were fixed with a blade-plate or condylar buttress plate; two, with an antegrade locked nail; and one, with an antegrade locked nail and a compression plate. Seven unicortical, five bicortical, and one tricortical allograft struts, with an average length of 10 cm, were used. Autogenous iliac bone grafts were inserted into the nonunion site and between the allograft and host femur. The average time from the surgery to the latest follow-up examination was thirty-four months (range, twelve to seventy months). Results: All nonunions united, at an average of five months. The average arc of knee motion improved from 45° preoperatively to 73° postoperatively. According to The Hospital for Special Surgery knee rating system, the average knee score improved from 20 points preoperatively to 71 points at the latest follow-up examination. Three patients had hardware removed after healing of the nonunion, and one patient underwent quadricepsplasty for knee contracture. There were no postoperative infections. Two patients had shortening of the limb of >2 cm. Conclusion: Open reduction and internal fixation supplemented with allograft struts and autogenous bone graft is an effective treatment for nonunion of the distal part of the femur. Level of Evidence: Therapeutic study, Level IV (case series [no, or historical, control group]). See Instructions to Authors for a complete description of levels of evidence.
AB - Background: The purpose of this retrospective study was to analyze the results of treatment of nonunions of the distal part of the femur with internal fixation combined with cortical allograft struts and autogenous bone-grafting. Methods: Thirteen patients with a distal femoral nonunion were treated with open reduction and internal fixation combined with deep-frozen cortical allograft struts and autogenous iliac bone grafts. The level of nonunion was infraisthmal in three patients and supracondylar in ten. Ten nonunions were fixed with a blade-plate or condylar buttress plate; two, with an antegrade locked nail; and one, with an antegrade locked nail and a compression plate. Seven unicortical, five bicortical, and one tricortical allograft struts, with an average length of 10 cm, were used. Autogenous iliac bone grafts were inserted into the nonunion site and between the allograft and host femur. The average time from the surgery to the latest follow-up examination was thirty-four months (range, twelve to seventy months). Results: All nonunions united, at an average of five months. The average arc of knee motion improved from 45° preoperatively to 73° postoperatively. According to The Hospital for Special Surgery knee rating system, the average knee score improved from 20 points preoperatively to 71 points at the latest follow-up examination. Three patients had hardware removed after healing of the nonunion, and one patient underwent quadricepsplasty for knee contracture. There were no postoperative infections. Two patients had shortening of the limb of >2 cm. Conclusion: Open reduction and internal fixation supplemented with allograft struts and autogenous bone graft is an effective treatment for nonunion of the distal part of the femur. Level of Evidence: Therapeutic study, Level IV (case series [no, or historical, control group]). See Instructions to Authors for a complete description of levels of evidence.
UR - https://www.scopus.com/pages/publications/0037362911
U2 - 10.2106/00004623-200303000-00006
DO - 10.2106/00004623-200303000-00006
M3 - 文章
C2 - 12637428
AN - SCOPUS:0037362911
SN - 0021-9355
VL - 85
SP - 436
EP - 440
JO - Journal of Bone and Joint Surgery
JF - Journal of Bone and Joint Surgery
IS - 3
ER -