Evaluation of Treatment Outcomes for Femoral Shaft Nonunion Fixed with Intramedullary Nail, with Addition of Plate and Bone Graft

Introduction:Femoral shaft nonunion is a serious and challenging complication following intramedullary nailing requiring effective interventions to achieve successful bone union.Materials and Methods:In this retrospective cross-sectional study, 20 patients with femoral shaft nonunion previously treated with intramedullary nailing underwent revision surgery with augmentation plating and bone grafting.Results:The mean age of patients was 42.5 years, and 90% achieved complete bone union. The average union time was 16.2 weeks. Factors influencing outcomes included age, underlying diseases, fracture type, and the time to revision surgery. Compared to a historical control group treated with revision nailing alone, this study showed significantly reduced healing time and improved function. Limited complications included superficial infections managed conservatively.Conclusion:The findings highlight augmentation plating and bone grafting as an effective and reliable approach for treating femoral shaft nonunion after intramedullary nailing. Future prospective studies with larger samples and long-term follow-up are recommended to assess treatment durability and possible complications. Additionally, investigating factors affecting recovery and quality of life could improve treatment protocols.