ABSTRACT

Objective: To evaluate the efficacy of using additional locking plate-derived Poller screws to treat post-intramedullary nailing for femoral non-union was investigated.

Methods: Between January 2009 and April 2012, six patients who underwent post-intramedullary nailing for femoral non-union were studied. Three, one, and two patients had femoral fractures in the proximal one-third, middle third and distal third, respectively. While the original intramedullary nails were retained, eight-to-nine hole locking plates were used for fixation and two-to-three cortical bone screws were applied to both sides of the fracture to ensure the stability of the intramedullary nail sagittal plane. One-to-two pieces of locking nails were inserted tightly next to the intramedullary nails to ensure a stable coronal plane. Autologous iliac bone grafts were performed around the fractures in all cases.

Results: Follow-up evaluations were conducted between 10 and 17 months (mean, 13.8 months). The operative time was 110–160 minutes and the blood loss was 300–500 mL. Bone pain was relieved in 1 month. Continuous callus was observed after 4–6 months (mean, 4.83 months) based on imaging. There were no infections, loosening of internal fixation, or rupture. All patients were able to walk bearing weight within 3 months.

Conclusion: An additional locking plate and the derived Poller screw technique effectively improved local rotation instability and is an effective and simple treatment method for femoral non-union after intramedullary nailing.