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 journalArticle

2 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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    Park, K. C., Oh, C. W., Kim, J. W., Park, K. H., Oh, J-K., Park, I. H., Kyung, H. S., & Heo, J. (2017). Minimally invasive plate augmentation in the treatment of long-bone non-unions. Archives of Orthopaedic and Trauma Surgery, 137(11), 1523-1528. https://doi.org/10.1007/s00402-017-2773-0