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What Is the Best Treatment of the Femoral Shaft Nonunion after Intramedullary Nailing? A Systematic Review

Nonunion (NU) is one of the most feared complications of femoral shaft fracture treatment. Femoral shaft fracture treatment is often linked with poor bone stock and reduced bone metabolism. In this paper, the goal is to carefully analyze the best treatment options for patients who developed nonunion...

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Autores principales: Bianco Prevot, Luca, Nannini, Alessandra, Mangiavini, Laura, Bobba, Andrea, Buzzi, Sara, Sinigaglia, Federico, Peretti, Giuseppe
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10381168/
https://www.ncbi.nlm.nih.gov/pubmed/37511883
http://dx.doi.org/10.3390/life13071508
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author Bianco Prevot, Luca
Nannini, Alessandra
Mangiavini, Laura
Bobba, Andrea
Buzzi, Sara
Sinigaglia, Federico
Peretti, Giuseppe
author_facet Bianco Prevot, Luca
Nannini, Alessandra
Mangiavini, Laura
Bobba, Andrea
Buzzi, Sara
Sinigaglia, Federico
Peretti, Giuseppe
author_sort Bianco Prevot, Luca
collection PubMed
description Nonunion (NU) is one of the most feared complications of femoral shaft fracture treatment. Femoral shaft fracture treatment is often linked with poor bone stock and reduced bone metabolism. In this paper, the goal is to carefully analyze the best treatment options for patients who developed nonunion after the intramedullary nailing of a femoral shaft fracture. A systematic review of the literature available in the PubMed, EMBASE and Cochran library databases was carried out, and 16 studies were included. Exclusion criteria included case reports and case series that do not have data about clinical outcomes or functional outcomes and included fewer than 10 patients. The reviewed data provide evidence for very good results about the treatment of this pathology with exchanging intramedullary nails or the implantation of a plate and screws (general healing rate of 96.3%). Moreover, the data support the utilization of autologous bone graft in order to stimulate the healing process. In conclusion, the choice between these two types of treatment must be guided by the type of pseudarthrosis that the patient presents. Additionally, bone grafting or growth factors promote bone regenerative processes, especially in patients with oligo-atrophic pseudoarthrosis.
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spelling pubmed-103811682023-07-29 What Is the Best Treatment of the Femoral Shaft Nonunion after Intramedullary Nailing? A Systematic Review Bianco Prevot, Luca Nannini, Alessandra Mangiavini, Laura Bobba, Andrea Buzzi, Sara Sinigaglia, Federico Peretti, Giuseppe Life (Basel) Systematic Review Nonunion (NU) is one of the most feared complications of femoral shaft fracture treatment. Femoral shaft fracture treatment is often linked with poor bone stock and reduced bone metabolism. In this paper, the goal is to carefully analyze the best treatment options for patients who developed nonunion after the intramedullary nailing of a femoral shaft fracture. A systematic review of the literature available in the PubMed, EMBASE and Cochran library databases was carried out, and 16 studies were included. Exclusion criteria included case reports and case series that do not have data about clinical outcomes or functional outcomes and included fewer than 10 patients. The reviewed data provide evidence for very good results about the treatment of this pathology with exchanging intramedullary nails or the implantation of a plate and screws (general healing rate of 96.3%). Moreover, the data support the utilization of autologous bone graft in order to stimulate the healing process. In conclusion, the choice between these two types of treatment must be guided by the type of pseudarthrosis that the patient presents. Additionally, bone grafting or growth factors promote bone regenerative processes, especially in patients with oligo-atrophic pseudoarthrosis. MDPI 2023-07-04 /pmc/articles/PMC10381168/ /pubmed/37511883 http://dx.doi.org/10.3390/life13071508 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Systematic Review
Bianco Prevot, Luca
Nannini, Alessandra
Mangiavini, Laura
Bobba, Andrea
Buzzi, Sara
Sinigaglia, Federico
Peretti, Giuseppe
What Is the Best Treatment of the Femoral Shaft Nonunion after Intramedullary Nailing? A Systematic Review
title What Is the Best Treatment of the Femoral Shaft Nonunion after Intramedullary Nailing? A Systematic Review
title_full What Is the Best Treatment of the Femoral Shaft Nonunion after Intramedullary Nailing? A Systematic Review
title_fullStr What Is the Best Treatment of the Femoral Shaft Nonunion after Intramedullary Nailing? A Systematic Review
title_full_unstemmed What Is the Best Treatment of the Femoral Shaft Nonunion after Intramedullary Nailing? A Systematic Review
title_short What Is the Best Treatment of the Femoral Shaft Nonunion after Intramedullary Nailing? A Systematic Review
title_sort what is the best treatment of the femoral shaft nonunion after intramedullary nailing? a systematic review
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10381168/
https://www.ncbi.nlm.nih.gov/pubmed/37511883
http://dx.doi.org/10.3390/life13071508
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