Exchange nailing and percutaneous bone grafting for management of aseptic non-union of the femur

Introduction Non-union of femur fracture is a known complication, managed by various methods, including exchange nailing. Additional bone grafting is known to enhance fracture healing. Percutaneous bone grafting has been reported for tibia and humerus in the literature. The authors report a series of aseptic non-union of the femoral shaft managed by exchange nailing, supplemented with percutaneous reamer debris grafting. Materials and methods Our purpose was to deliver more vital osteoblasts to the fracture gap through a percutaneous route. The reamer debris, which accumulated at the proximal entry point and collected from the reamer flutes, was percutaneously delivered into the non-union site, after disturbing the fibrous tissue around the fracture. This study analysed the management of aseptic non-union of five cases of aseptic nonunion of the femur in adults. Results The fracture was found healed when there was bony continuity in at least three cortices and the patient was able to bear weight without pain. Conclusion We achieved sound union in all five cases of aseptic non-union of the femur with our technique of exchange nailing with percutaneous bone grafting.