A Comparative Study between Intramedullary Nailing Versus Planting for the Treatment of Diaphyseal Nonunited Fractures

Nonunion is one of the serious complications of fractures and it occurs when the fracture has little or no potential to heal. Operative treatment is usually the treatment of choice for established nonunion fractures and this can be either with intramedullary locking nails, plates and screws, or ilizarov technique. The aim of this study is to assess the value of union among patients complaining of nonunion fractures treated by intramedullary nailing or plating as regard rate of union and complications, and reporting important risk factors affecting outcome. In this retrospective comparative study conducted between march 2018 and February 2019 in Al-Numan Teaching Hospital and Baghdad private hospitals.30 patients with history of nonunion fractures treated by either intramedullary nailing or plate and scr ews were followed up until union occurred (3-6) months. Group1 (15 patients) male (10) female (5) (mean age, 34.87+13.061) years treated by locked plate with bone graft. Group2 (15 patients) male (11) female (4) (mean age, 43.87+16.656) years treated by locked intramedullary nailing with or without bone graft. The results of both groups regarding union were compared. All patients in both groups had union as a final outcome after procedure of fixation, the time of union ranged between (2-5) months, the mean time of union for patients treated with plate and screws was (3.60) months and was less than that for patients treated with intramedullary nails which was (4.13) months, this difference was clinically significant. the period of follow up was between (3-6) months. In conclusion thelocked plates and screws and intramedullary locked nails have a good final outcome regarding union for nonunion fractures treated by these procedures of fixation, but union in patients treated with locked plate and screws was faster than patients treated with locked intramedullary nails.