Document Detail

The use of endosteal substitution in the treatment of recalcitrant nonunions of the femur: report of seven cases.
MedLine Citation:
PMID:  8926549     Owner:  NLM     Status:  MEDLINE    
Seven patients, with an average age of 53 years, were treated for bone loss or recalcitrant nonunions of the femur. The average duration from initial injury to presentation was 37 months (range 4-92 months). The patients had undergone one to eight (mean, 3.9) previous surgical attempts at achieving union. The nonunion involved the diaphysis in three patients, the diaphyseal-supracondylar junction in three patients, and the pertrochanteric region in one patient. All patients were treated using a standard lateral plate in combination with an endosteal plate and primary iliac crest bone grafting. The mean surgical time was 6.3 h, and the average blood loss was 1.7 L. There were three complications, including one superficial wound infection, one nonfatal pulmonary embolism, and one wound hematoma. At a mean follow-up of 12.6 months (range 4-24 months), all fractures had healed with an average time to union of 19.2 weeks (range 15-36 weeks). Knee flexion averaged 118 degrees (range 100-135 degrees), and all patients were satisfied with the operative procedure. Endosteal plating, in combination with a standard lateral plate and iliac crest bone-grafting, can successfully treat difficult nonunions of the femur.
T M Matelic; M T Monroe; J W Mast
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of orthopaedic trauma     Volume:  10     ISSN:  0890-5339     ISO Abbreviation:  J Orthop Trauma     Publication Date:  1996  
Date Detail:
Created Date:  1996-10-25     Completed Date:  1996-10-25     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8807705     Medline TA:  J Orthop Trauma     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1-6     Citation Subset:  IM    
Department of Orthopaedic Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA.
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MeSH Terms
Blood Loss, Surgical
Bone Plates*
Bone Transplantation / methods*
Femoral Fractures / physiopathology,  radiography,  surgery*
Follow-Up Studies
Fracture Fixation, Internal / methods*
Fracture Healing*
Fractures, Ununited / physiopathology,  radiography,  surgery*
Middle Aged
Range of Motion, Articular
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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