PMC8464431_01
The visible nonunion with the classic plate in AP view.
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fig1
X-ray showed an atrophic nonunion after "classic" plate fixation of the distal femur fracture with bone loss (Figures 1 and 2).
The visible nonunion with the classic plate in LL view.
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fig2
X-ray showed an atrophic nonunion after "classic" plate fixation of the distal femur fracture with bone loss (Figures 1 and 2).
The nonunion with the failed classic plate in AP view.
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fig3
Classic X-ray showed plate failure and fragment dislocation (Figure 3).
The debrided nonunion with autologous cancellous bone graft stabilized with an LCP in AP view.
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fig4
The postoperative recovery was uneventful, and classic X-ray showed proper plate position (Figures 4 and 5).
The debrided nonunion with autologous cancellous bone graft stabilized with an LCP in LL view.
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fig5
The postoperative recovery was uneventful, and classic X-ray showed proper plate position (Figures 4 and 5).
The nonunion is widened, with the plate providing stability in AP view.
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fig6
X-rays showed a halt in bone healing (Figure 6), and another procedure was recommended.
The first stage of the induced membrane technique (IMT), the nonunion is partially filled with PMMA cement. The cement is encircled.
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fig7
The first stage of the induced membrane technique (operation of Masquelet) with a poly-methyl methacrylate (PMMA) cement spacer was performed: the fracture fragments were debrided, and the now widened fracture site was filled with cement (PMMA) (Figure 7).
The nonunion is readily visible, and the LCP has failed in AP view.
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fig8
She complained about the sudden onset of pain in the left femur during walking, and X-ray confirmed plate breakage (Figure 8).
The plate was removed, the nonunion was stabilized with a locked intramedullary nail (the position of the nail is secured with Poller blocking screws (marked by arrows)), and the defect was filled with a mixture of cancellous bone graft and Ca-P cement (encircled).
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fig9
The defect was filled with calcium phosphate cement (Innotere GMBH) (Figure 9).
Healing of the nonunion after nailing and dynamization in a favorable position is evident, AP view.
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fig10
Follow-up was regular, and bone healing was uneventful (Figures 10-12).
Healing of the nonunion after nailing and dynamization in a favorable position is evident, and the tip of the nail does not protrude into the abductor muscles, AP view.
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fig11
Follow-up was regular, and bone healing was uneventful (Figures 10-12).
Healing of the nonunion after nailing and dynamization in a favorable position is evident, LL view.
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fig12
Follow-up was regular, and bone healing was uneventful (Figures 10-12).