OBJECTIVETo analyze rationality of internal fixation with original fixation in the second operation for femoral nonunion.

METHODSA retrospective study was conducted to analyze the clinical data of 19 femoral nonunion patients treated by internal fixation with original fixation in the second operation since January 2009 to July 2014, including 14 males and 5 females with an average age of (43.63 ± 3.95) years old ranging from 18 and 75 years old. The original fixations involved plate fixation in 11 cases and interlocking intramedullary nail in 8 cases (including 3 cases of retrograde interlocking intramedullary nails). There were 13 cases of atrophic nonunion and 6 cases of hypertrophic nonunion in pathological classification. After second operation, the fracture healing time, Harris hip score and range of motion of the knee joint was recorded and compared with preoperative.

RESULTSAfter the second operatioin, all patients were followed up for 6 to 30 months with an average of (18.67 ± 7.59) months. All patients got fracture healing, and the fracture radiological healing time was from 7 to 29 months with an average of (15.78 ± 4.97) months. Harris hip scores were improved from preoperative 62.37 ± 19.48 to postoperative 87.42 ± 8.86. The range of motion of the knee joint was improved from preoperative (52.16 ± 20.10)° to postoperative (96.32 ± 22.10)°.

CONCLUSIONIt has a better clinical healing rate for using original fixation to treat femoral nonunions, and theoretically speaking it was rationality.