Authors : Dr. Vinay V Sherlekar

Volume/Issue : Volume 9 - 2024, Issue 10 - October

Google Scholar : https://tinyurl.com/4bzfv48v

Scribd : https://tinyurl.com/36da9y62

DOI : https://doi.org/10.38124/ijisrt/IJISRT24OCT396

Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.

Abstract : Aim: To evaluate the novel methods in revision surgery to tackle non-union fractures of different cases of patients.  Background: Non-union of bone is the body's inability to heal a fracture. The most agreed-upon standard definition of non -union made by the FDA is a fracture that persists for a minimum of nine months without signs of healing for three months. Non-union fractures of femur pose significant challenges in orthopaedic surgery, often requiring revision procedures to achieve successful bone healing. In cases where the initial implant has failed, innovative solutions are necessary to promote bone union and functional recovery.  Case Description: The case report presented with four different geriatric patients had previously undergone implants surgery, which subsequently failed to promote bone healing. The patients were reoperated using a proximal femur nail (PFN) and augmented with a locking compressed plate (LCP) to address the non-union. The combination of the PFN and LCP along with bone graft successfully provided stability to the fracture site, promoting bone union, and enabling functional recovery. Radiographic evidence and clinical assessment demonstrated excellent healing progress.  Conclusion: This case study emphasizes the significance of customized care for non-union femur shaft fractures, particularly in cases where implant failure has occurred in the past. When treating difficult non-union fractures, 35mm locking plate and bone graft coupled can be a useful tool for stabilizing the fracture and promoting effective bone healing.  Clinical Significances: This case report exemplifies the need for innovative and individualized approaches in the management of challenging non-union femur fractures. Locking compression plates along with PFN and bone graft present a viable method, but further investigation and clinical data are needed to confirm the efficacy and long- term results of this strategy. Even with such complex orthopedic settings, successful outcomes can be attained via meticulous planning and a patient-centered approach. Moreover, to prevent revision, the initial treatment must be the best.

Keywords : Proximal Femoral Nails (PFN), Locking Compression Plates (LCP), Closed Reduction And Internal Fixation (CRIF), Diabetes Mellitus (DM), Hypertension (HTN), And Chronic Kidney Disease (CKD)

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