Objective: The efficacy of using additional locking plate-derived Poller screws to treat post-intramedullary nailing for femoral nonunion was investigated.
Methods: Between January 2009 and April 2012, six patients who underwent post-intramedullary nailing for femoral nonunion 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, 8-9 hole locking plates were used for fixation and 2-3 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 min 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 nonunion after intramedullary nailing.
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