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Three-stage treatment protocol for recalcitrant distal femoral nonunion

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

In this study, we proposed a three-stage treatment protocol for recalcitrant distal femoral nonunion and aimed to analyze the clinical results.

Materials and methods

We retrospective reviewed 12 consecutive patients with recalcitrant distal femoral nonunion undergoing our three-stage treatment protocol from January 2010 to December 2014 in our institute. The three-stage treatment protocol comprised debridement of the nonunion site, lengthening to eliminate leg length discrepancy, deformity correction, stabilization with a locked plate, filling of the defect with cement spacer for inducing membrane formation, and bone reconstruction using a cancellous bone autograft (Masquelet technique) or free vascularized fibular bone graft. The bone union time, wound complication, lower limbs alignment, amount of lengthening, knee range of motion, and functional outcomes were evaluated.

Results

Osseous union with angular deformity <5° and leg length discrepancy <1 cm were achieved in all the patients. The average amount of lengthening was 5.88 cm (range 3.5–12 cm). Excellent or good outcomes were obtained in 9 patients.

Conclusions

Although the current study involved only a small number of patients and the intervention comprised three stages, we believe that such a protocol may be a valuable alternative for the treatment of recalcitrant distal femoral nonunion.

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Acknowledgements

We thank all patients for participating in the study and Editage Company for the English editing.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, E-Da Hospital, I-Shou University, 1, E-Da Road, Jiau-Shu Tsuen, Yan-Chau Shiang, 824, Kaohsiung City, Taiwan, ROC

    Ching-Hou Ma, Yen-Chun Chiu, Yuan-Kun Tu, Cheng-Yo Yen & Chin-Hsien Wu

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  1. Ching-Hou Ma
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  2. Yen-Chun Chiu
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Correspondence to Chin-Hsien Wu.

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No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

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Ma, CH., Chiu, YC., Tu, YK. et al. Three-stage treatment protocol for recalcitrant distal femoral nonunion. Arch Orthop Trauma Surg 137, 489–498 (2017). https://doi.org/10.1007/s00402-017-2634-x

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  • DOI: https://doi.org/10.1007/s00402-017-2634-x

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