Risk Factors of Taistman et al for Nonunion of a Femoral Shaft Fracture After Femoral Nailing

 

Patient selection: femoral shaft (diaphyseal) fracture treated with intramedullary nail placement

 

Nonunion was defined as a fracture that was unhealed after standard therapy and that required additional procedures to achieve union. Radiographic findings associated with nonunion included:

(1) persistent fracture line

(2) lack of bridging trabeculae

(3) cortical continuity on more than one cortex

(4) lack of resolution in these features on sequential radiographs

 

Risk factors for fracture nonunion:

(1) use of tobacco

(2) open fracture, especially if there was significant bone loss

(3) delay in weight bearing

 

Based on these findings:

(1) the patient should be encouraged to cease or reduce tobacco use

(2) the patient should start weight-bearing as soon as feasible