Functional and radiological outcome following operative skeletal stabilisation with bone grafting in distal femur non-unions: a study of 21 patients

Navin Balasubramanian, Sindhuja P.


Background: The study was done to assess the functional and radiological outcome after operative skeletal stabilisation with bone grafting in 21 patients who presented to us with distal femur non-unions.

Methods: Between August 2008 and October 2015, 21 patients (M:F- 14:7)  with established non-unions of the distal femur were included. All patients presented to us with established non-union following treatment with a native bone setter using splints.  There were 16 patients with AO Type A, 4 with AO Type B and one patient with Type C. All patients underwent open reduction, internal fixation with plate and screws and bone grafting. Serial follow-ups were done at 4, 8, 12, 16, 20, 24 weeks and 6 monthly thereafter.

Results: All 21 patients had complete fracture healing at average of 19 weeks (Range 16-24). Knee flexion (ROM) improved from an average 16® pre-op to 66® post-operatively. There were no implant failure, infection or non-unions in our study. The Knee Society score improved from 54 pre-operatively to 74 post-operatively at last follow-up.

Conclusions: Even in established non-unions, good results can be expected if good surgical technique is followed and with bone grafting satisfactory union rated can be achieved. Knee ROM also improves with dedicated postoperative rehabilitation.


Distal femur non-unions, Native bone setter, Knee society score

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