Methods Fourteen patients with aseptic fractures that failed
to unite after intramedullary nailing (IMN) of the femur
were treated by augmentation of fixation by dynamic
compression plate (DCP) with the nail in situ. In six of
them that had axial or rotational malalignment, direct
reduction of the bone fragments and plating were done.
Iliac bone grafting was performed in nine cases, when there
were gaps between the fragments and in atrophic nonunions.
Patients were followed-up for an average of
26 months.
Results All patients had radiological union in an average of
4.3 months with an improvement in alignment, range of
motion and shortening.
Conclusions For failed IMN of the femur, augmentation of
fixation by compression plate, with the nail in situ, is a
good line of treatment. In cases with malalignment,
correction was possible followed by plate augmentation