Augmentative locking compression plate fixation for the management of long bone nonunion after intramedullary nailing

Intramedullary nailing is widely used in the treatment of long bone fractures. But some patients suffer from nonunion after receiving intramedullary nailing. This paper investigates the methods and effects of locking compression plate (LCP) in the treatment of long bone nonunion after intramedullary nailing. A total of 6 patients (4 males, 2 females) with long bone nonunion were enrolled. All these patients had previously undergone intramedullary nailing for fractures of long bones (4 femurs, 2 tibiae). The average time from injury to LCP treatment was 12.2 months. The locking compression plate was applied over the intramedullary nail, and unicortical purchase achieved with locking head screws due to underlying nails. Autologous bone grafting was done in all cases. Six patients were followed up for 12-20 months (mean 14.2 months). X-ray imaging showed bone callus at the broken ends of the fracture at 3-7 (mean 4.5) months after surgery. All patients did not have any complications such as infection, breaking or loosening of the LCPs. LCP can be used for the treatment of long bone nonunion after intramedullary nailing for its convenience, minimal invasion and curative effect.