• Gang Zhao, Bo-song Zhang, Lin Sun, and Xin-bao Wu.
• Department of Orthopaedics, Beijing Jishuitan Hospital, Beijing 100035, China.
• Zhonghua Wai Ke Za Zhi. 2009 Aug 15; 47 (16): 1232-5.

ObjectiveTo evaluate the principle and treatment of rotational unstable nonunion of the femoral shaft fracture after interlocking nailing.MethodsFrom April 2003 to June 2007, 18 cases of rotational unstable nonunion of femoral shaft fractures after interlocking nailing were treated with exchanged reamed nailing and/or LCP fixation and iliac bone graft. The average age was 40 years old (from 22 to 52).ResultsAll patients were followed up for an average time of 28 months (from 12 to 58). All the fractures were united in an average time of 7 months (from 6 to 8). There were no perioperative complications occurred and no wound infection were observed. No loosening was found around the implant till the last follow-up.ConclusionsRotational instability is one of the reasons of nonunion of femoral shaft fracture after interlocking nailing. Reaming and nail exchanging or LCP fixation with iliac bone graft are the appropriate methods which can achieve a great clinic results.

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