What Is the Best Treatment of the Femoral Shaft Nonunion after Intramedullary Nailing? A Systematic Review

Nonunion (NU) is one of the most feared complications femoral shaft fracture treatment. Femoral treatment often linked with poor bone stock and reduced metabolism. In this paper, goal to carefully analyze best options for patients who developed nonunion after intramedullary nailing a fracture. A systematic review literature available in PubMed, EMBASE Cochran library databases was carried out, 16 studies were included. Exclusion criteria included case reports series that do not have data about clinical outcomes or functional fewer than 10 patients. The reviewed provide evidence very good results pathology exchanging nails implantation plate screws (general healing rate 96.3%). Moreover, support utilization autologous graft order stimulate process. conclusion, choice between these two types must be guided by type pseudarthrosis patient presents. Additionally, grafting growth factors promote regenerative processes, especially oligo-atrophic pseudoarthrosis.