OBJECTIVES: The purpose of this study was to compare the results between exchange nailing (EN) and augmentation plating (AP) with a nail left in situ for nonisthmal femoral shaft nonunion after femoral nailing. DESIGN:: Retrospective data analysis, November 1996-March 2006. SETTING: A level I trauma center. PATIENTS: Eighteen patients with 18 nonisthmal femoral nonunions. INTERVENTION: Seven patients with 7 fractures treated for nonisthmal femoral shaft nonunions after femoral nailing with EN and 11 patients with 11 fractures treated for nonisthmal femoral shaft nonunions after nailing with AP combined with bone grafting. MAIN OUTCOME MEASURE: Union and complications. RESULTS: Five nonunions in the EN group failed to achieve union (72% failure rate), whereas all 11 pseudarthroses in the AP group obtained osseous union. Fisher exact test showed a higher nonunion rate of EN compared with AP for nonisthmal femoral shaft nonunion (odds ratio, 6.5; P = 0.002). CONCLUSIONS: AP with autogenous bone grafting may be a better option than EN for nonisthmal femoral nonunions.
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机译：目的：本研究的目的是比较股骨钉固定后非原位股骨干骨不连的钉子交换钉（EN）和增强钢板（AP）的结果。设计：：回顾性数据分析，1996年11月至2006年3月。地点：一级创伤中心。患者：18例患者有18例非峡部股骨不愈合。干预：7例7例骨折的EN股骨钉异位治疗不全股骨干骨不连，11例11例骨折的AP植骨结合股骨钉不全治疗。主要观察指标：合并及并发症。结果：EN组中有5个骨不愈合未能达到愈合（失败率72％），而AP组中的11个假月见草均获得了骨性愈合。 Fisher精确测试显示，非峡部股骨干不愈合的EN的不愈合率比AP高（赔率比6.5; P = 0.002）。结论：对于非峡部股骨不愈合，自体植骨的AP可能比EN更好。
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