Minimally invasive plate augmentation in the treatment of long-bone non-unions

Ki Chul Park, Chang Wug Oh, Joon Woo Kim, Kyeong Hyeon Park, Jong-Keon Oh, Il Hyung Park, Hee Soo Kyung, Jeong Heo

    Research output: Contribution to journalArticlepeer-review

    3 Citations (Scopus)

    Abstract

    Introduction: Exchange nailing is most acceptable for treating hypertrophic non-union of the long bones, requiring the removal of previously fixed implant. However, its main effect of mechanical stabilization is controversial in non-isthmal area. We hypothesized that minimally invasive plate augmentation over the non-union site may have a better option, without the need of bone grafting or removing pre-existing implants. Materials and methods: Seventeen patients with hypertrophic non-union of the long bones between 2010 and 2014 on radiography who previously underwent intramedullary (IM) nailing or plate osteosynthesis for long-bone fractures were included. A locking compression plate was inserted with at least three mono- or bicortical screws at each proximal and distal segment. Broken or loosened interlocking screws of IM nail were simultaneously re-fixed. Fracture site exposure, pre-fixed implant removal, and bone grafting were not performed. We investigated whether union occurred and analyzed functional outcomes and complications. Results: Eleven femoral and six tibial non-unions were prospectively included. In the pre-existing implants, 13 nails and 4 plates were found. All cases achieved union at a mean 22.7 weeks. One case of superficial infection was managed with oral antibiotics. Deep infection or implant failure did not occur. Conclusions: Minimally invasive plate augmentation can achieve additional stability and promote healing of hypertrophic non-union of the long bones. When indicated, this technique is the least invasive alternative to exchange nailing and reduces surgical risks in the treatment of diaphyseal non-union.

    Original languageEnglish
    Pages (from-to)1523-1528
    Number of pages6
    JournalArchives of Orthopaedic and Trauma Surgery
    Volume137
    Issue number11
    DOIs
    Publication statusPublished - 2017 Nov 1

    Keywords

    • Bone graft
    • Exchange nailing
    • Hypertrophic non-union
    • Minimally invasive plate augmentation

    ASJC Scopus subject areas

    • Surgery
    • Orthopedics and Sports Medicine

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