Derotational Plate Augmentation with Retention of Intramedullary Interlocking Nail in Resistant Nonunion at Distal Femur Shaft

Background: Non-union in femur shaft after satisfactory treatment with closed intramedullary interlocking nail is not very common. This nonunion always a challenging condition for surgeon. These are usually treated by dynamization, close exchange larger diameter, retention of and onlay bone graft, removal fixed plates application cast brace sometimes applications external fixators. But no is’ gold standard’ the rotational instability blamed to be one most common reason nonunion. Aim: To control instability, we did plate augmentation or without grafts removing treat this Methods: Total patients were 16. Proximal distal screws removed, site was opened, compression at done, broad DCP applied as de rotation grating. We excluded fracture less than one-year duration infective Results: In 12 grafting done where there callus suspicion atrophic non-union. got union all patients. 6.25 months average time union. 13 between primary secondary surgery. 71 minutes means surgical time. Complications implant failure noted. 0.9 cm residual limb shortening 115 degrees range motion knee joint. Conclusion: Nonunion situ reliable effective procedure Keywords: Distal femur, plate, External fixator. Bone