Plate augmentation and hybrid bone grafting are effective treatments for atrophic nonunion of the femur with the original intramedullary nail retained in situ

Abstract The purpose of this study is to evaluate the efficacy of plate augmentation and hybrid bone grafting for treating atrophic nonunion of the femur with original intramedullary nail retained in situ.In this study, 36 patients with atrophic nonunion of the femur who underwent surgery using the...

Full description

Bibliographic Details
Main Authors: Huang Qiang, Zhang Congming, Ma Teng, Zhang Kun, Wang Chaofeng
Format: Article
Language:English
Published: Nature Portfolio 2024-03-01
Series:Scientific Reports
Subjects:
Online Access:https://doi.org/10.1038/s41598-024-57809-1
_version_ 1797233677515620352
author Huang Qiang
Zhang Congming
Ma Teng
Zhang Kun
Wang Chaofeng
author_facet Huang Qiang
Zhang Congming
Ma Teng
Zhang Kun
Wang Chaofeng
author_sort Huang Qiang
collection DOAJ
description Abstract The purpose of this study is to evaluate the efficacy of plate augmentation and hybrid bone grafting for treating atrophic nonunion of the femur with original intramedullary nail retained in situ.In this study, 36 patients with atrophic nonunion of the femur who underwent surgery using the technique of plate augmentation and a hybrid bone grafting while retaining the original intramedullary nail in situ in Xi’an Honghui Hospital from January 2019 to December 2021 were enrolled. 28 patients who met the inclusion and exclusion criteria were ultimately included in the study. These 28 patients, consisting of 20 males and 8 females with a mean age of 38 years, were evaluated based on factors such as operation time, intraoperative blood loss, the average hospitalization days. Additionally, the results and function of these patients were evaluated by union time, Wu’s scores of limb function and incidence of serious complications.All 28 patients achieved bone union at the 12 month follow-up, with an average follow-up time of 14.6 ± 4.2 months.The average operation time was 68.3 ± 11.2 min, and the average intraoperative blood loss was 140 ± 22.6 ml. Patients were hospitalized for an average of 5.8 ± 1.1 days. Full clinical and radiological bone union was achieved on average at 5.1 ± 1.9 months. The mean value of Wu's scores at the 12 month follow-up was significantly higher than before the operation. Limb function was excellent in 27 patients and good in one patient at the 12 month follow-up. However, five patients experienced the lower limb vein thrombosis, including one deep vein thrombosis and four lower limb intermuscular vein thromboses. One patient had a superficial infections of the surgical incision site, while three patients reported pain and numbness where their iliac bone graft was extracted at the 12 month follow-up. The technique of plate augmentation and hybrid bone grafting, combined with retaining the original intramedullary nail in situ has been shown to be a safe, effective, simply and standardizable practice for treating atrophic femoral nonunion with an intact original IMN fixation.
first_indexed 2024-04-24T16:19:58Z
format Article
id doaj.art-97903dd7f938457d9e1e65f2794c7297
institution Directory Open Access Journal
issn 2045-2322
language English
last_indexed 2024-04-24T16:19:58Z
publishDate 2024-03-01
publisher Nature Portfolio
record_format Article
series Scientific Reports
spelling doaj.art-97903dd7f938457d9e1e65f2794c72972024-03-31T11:15:14ZengNature PortfolioScientific Reports2045-23222024-03-011411810.1038/s41598-024-57809-1Plate augmentation and hybrid bone grafting are effective treatments for atrophic nonunion of the femur with the original intramedullary nail retained in situHuang Qiang0Zhang Congming1Ma Teng2Zhang Kun3Wang Chaofeng4Department of Orthopaedic Surgery, Hong Hui Hospital, Xi’an Jiaotong University College of MedicineDepartment of Orthopaedic Surgery, Hong Hui Hospital, Xi’an Jiaotong University College of MedicineDepartment of Orthopaedic Surgery, Hong Hui Hospital, Xi’an Jiaotong University College of MedicineDepartment of Orthopaedic Surgery, Hong Hui Hospital, Xi’an Jiaotong University College of MedicineDepartment of Orthopaedic Surgery, Hong Hui Hospital, Xi’an Jiaotong University College of MedicineAbstract The purpose of this study is to evaluate the efficacy of plate augmentation and hybrid bone grafting for treating atrophic nonunion of the femur with original intramedullary nail retained in situ.In this study, 36 patients with atrophic nonunion of the femur who underwent surgery using the technique of plate augmentation and a hybrid bone grafting while retaining the original intramedullary nail in situ in Xi’an Honghui Hospital from January 2019 to December 2021 were enrolled. 28 patients who met the inclusion and exclusion criteria were ultimately included in the study. These 28 patients, consisting of 20 males and 8 females with a mean age of 38 years, were evaluated based on factors such as operation time, intraoperative blood loss, the average hospitalization days. Additionally, the results and function of these patients were evaluated by union time, Wu’s scores of limb function and incidence of serious complications.All 28 patients achieved bone union at the 12 month follow-up, with an average follow-up time of 14.6 ± 4.2 months.The average operation time was 68.3 ± 11.2 min, and the average intraoperative blood loss was 140 ± 22.6 ml. Patients were hospitalized for an average of 5.8 ± 1.1 days. Full clinical and radiological bone union was achieved on average at 5.1 ± 1.9 months. The mean value of Wu's scores at the 12 month follow-up was significantly higher than before the operation. Limb function was excellent in 27 patients and good in one patient at the 12 month follow-up. However, five patients experienced the lower limb vein thrombosis, including one deep vein thrombosis and four lower limb intermuscular vein thromboses. One patient had a superficial infections of the surgical incision site, while three patients reported pain and numbness where their iliac bone graft was extracted at the 12 month follow-up. The technique of plate augmentation and hybrid bone grafting, combined with retaining the original intramedullary nail in situ has been shown to be a safe, effective, simply and standardizable practice for treating atrophic femoral nonunion with an intact original IMN fixation.https://doi.org/10.1038/s41598-024-57809-1Atrophic nonunionFemurPlate augmentationHybrid bone graftingIntramedullary nail
spellingShingle Huang Qiang
Zhang Congming
Ma Teng
Zhang Kun
Wang Chaofeng
Plate augmentation and hybrid bone grafting are effective treatments for atrophic nonunion of the femur with the original intramedullary nail retained in situ
Scientific Reports
Atrophic nonunion
Femur
Plate augmentation
Hybrid bone grafting
Intramedullary nail
title Plate augmentation and hybrid bone grafting are effective treatments for atrophic nonunion of the femur with the original intramedullary nail retained in situ
title_full Plate augmentation and hybrid bone grafting are effective treatments for atrophic nonunion of the femur with the original intramedullary nail retained in situ
title_fullStr Plate augmentation and hybrid bone grafting are effective treatments for atrophic nonunion of the femur with the original intramedullary nail retained in situ
title_full_unstemmed Plate augmentation and hybrid bone grafting are effective treatments for atrophic nonunion of the femur with the original intramedullary nail retained in situ
title_short Plate augmentation and hybrid bone grafting are effective treatments for atrophic nonunion of the femur with the original intramedullary nail retained in situ
title_sort plate augmentation and hybrid bone grafting are effective treatments for atrophic nonunion of the femur with the original intramedullary nail retained in situ
topic Atrophic nonunion
Femur
Plate augmentation
Hybrid bone grafting
Intramedullary nail
url https://doi.org/10.1038/s41598-024-57809-1
work_keys_str_mv AT huangqiang plateaugmentationandhybridbonegraftingareeffectivetreatmentsforatrophicnonunionofthefemurwiththeoriginalintramedullarynailretainedinsitu
AT zhangcongming plateaugmentationandhybridbonegraftingareeffectivetreatmentsforatrophicnonunionofthefemurwiththeoriginalintramedullarynailretainedinsitu
AT mateng plateaugmentationandhybridbonegraftingareeffectivetreatmentsforatrophicnonunionofthefemurwiththeoriginalintramedullarynailretainedinsitu
AT zhangkun plateaugmentationandhybridbonegraftingareeffectivetreatmentsforatrophicnonunionofthefemurwiththeoriginalintramedullarynailretainedinsitu
AT wangchaofeng plateaugmentationandhybridbonegraftingareeffectivetreatmentsforatrophicnonunionofthefemurwiththeoriginalintramedullarynailretainedinsitu