*Corresponding Author: Ahmed Reda Elbestawy, Orthopedic Surgery Department, Faculty of Medicine, October 6 University, Giza, Egypt. Email: Ahmedelbestawy137@gmail.com
Background: Femoral shaft nonunion remains challenging, influenced by patient, biological, and mechanical factors, and is associated with variable outcomes despite available treatment options. This work aimed to evaluate union rate, as well as radiological and clinical outcomes, after plate augmentation (PA) with the remaining nail in cases of femoral non-unions, and to identify possible complications of the technique.
Methods: This retrospective study was carried out on 20 patients with non-union fractures treated with PA over an intramedullary nail (IMN), and included completed medical and radiological documentation. All patients were subjected to fracture level and fracture pattern, and type of non-union (Non-union was classified as oligotrophic, hypertrophic, or atrophic).
Results: Fracture Union was achieved in all patients (100%) with a mean time to union of 5.5 ± 1.14 months. The mean operative time was 103.9 ± 16.78 minutes, with a mean intraoperative blood loss of 381 ± 132.7 mL. According to Wu's criteria, radiological and clinical outcomes were excellent in 60% of patients and good in 35%. The mean follow-up duration was 29.8 ± 14.97 months.
Conclusions: PA over a retained IMN with iliac crest bone grafting achieved reliable union and good functional outcomes in aseptic femoral shaft non-union. The approach was safe, provided mechanical and biological support, and avoided the morbidity of nail removal or exchange.
Keywords: Plate Augmentation, Intramedullary Nail, Femoral Shaft Non-union, Bone Graft.
How to cite this article: Elbestawy AR, Morsy AM, Edward MA, Kotb MS, Abd Elkader KH. The outcome of plate over an intramedullary nail in treating non-united femoral fractures. Int J Drug Deliv Technol. 2026;16(7s): 386-396; DOI: 10.25258/ijddt.16.7s.40
Source of support: Nil.
Conflict of interest: None