1: J Bone Joint Surg Br 1997 Mar;79(2):289-94

Complex nonunion of fractures of the femoral shaft treated by wave-plateosteosynthesis.

Ring D, Jupiter JB, Sanders RA, Quintero J, Santoro VM, Ganz R, MartiRK.

Department of Orthopaedics, Massachusetts General Hospital, Boston 02114,USA.

We have treated 42 consecutive complex ununited fractures of the femoralshaft by wave-plate osteosynthesis at five different medical centres. Therewere 13 with previous infection, 12 with segmental cortical defects, and3 were pathological fractures. In 39 cases there had been previous internalfixation and 21 patients had had more than one earlier operation. Unionwas achieved in 41 patients at an average of six months, although threehad required a second bone graft. Two patients had recurrence of infectionand in one this resulted in the persistence of nonunion. There were no failuresof the implant. All 41 patients with union are now fully weight-bearing,but four have a leg-length discrepancy, one has axial malalignment, andnine have residual stiffness of the knee. These results are surprisinglygood, despite the complexity of the initial problem, and appear to confirmthe biological and mechanical advantages of the wave plate over the conventionalplate for such cases.

PMID: 9119859 [PubMed - indexed for MEDLINE]