Femoral shaft nonunions

Summary

Evidence from nine case series suggests rates of solid union may be lower and the complication frequency higher for exchange nailing of femoral shaft nonunions than with plate fixation. However, no comparative study was found to evaluate the efficacy and safety of these procedures and there were more series describing exchange nailing than plate fixation. Methodologically rigorous comparative studies with larger populations are necessary to establish the long term safety and efficacy of these two operative treatments and to evaluate the superiority of one treatment over another.