Nonunion of a Pertrochanteric Femur Fracture Due to a Low-Velocity Gunshot

摘要

The treatment of nonunions often can be a complex and challenging venture. This case report details the treat-ment of a young patient's pertrochanteric femoral nonunion due to a low-velocity gunshot. Fracture fixation and anion were attempted with various implants, including a sliding hip screw, blade plate, and proximal femoral locking plate; however, all eventually failed. Successful union ultimately was obtained only after use of a cephalo-medullary nail. There have been few reports in the literature on the failure of proximal femoral locking plates in the treatment of pertrochanteric femur fractures, though much has been published regarding the sliding hip serew and blade plate. Multiple options for use in nonunion surgery were used and discussed in this case, such as autogenous bone graft, bone morphogenic protein, and implantable bone stimulators.