Ipsilateral Femoral Fracture Non-Union and Delayed Union Treated By Hybrid Plate Nail Fixation and Vascularized Fibula Bone Grafting: A Case Report

• Published in: Malaysian orthopaedic journal Vol. 7; no. 2; pp. 41 - 44
• Main Authors: Chan, CK, Ng, WM, Merican, AM
• Format: Journal Article
• Language: English
• Published: Malaysian Orthopaedic Association 01-07-2013
• ISSN: 1985-2533; 2232-111X
• DOI: 10.5704/MOJ.1307.015

Non-union is a well recognized complication of femoral neck
fractures. The decision whether to attempt fracture fixation or
to resort to hip replacement is particularly difficult in patients
in the borderline age group in whom complex attempts at
gaining union may fail and later present a difficult revision.
On the other hand the patient may be young enough that
arthroplasty best be avoided . Besides, presence of ipsilateral
femoral shaft fracture with delayed union in addition to the
femoral neck non-union will pose major problems at
operation. We share our experience in treating a femoral neck
fracture non-union with ipsilateral femoral shaft delayed
union in the shaft and in the distal femur in a fifty years old
patient. The fracture was treated with an angle blade plate and
supracondylar nail supplemented with a free vascularised
fibular bone grafting and autologous cancellous graft. There
was radiological union at fourth month. At sixth months, the
patient was free of pain and able to walk without support.
Thus, we would like to suggest that vascularised fibula bone
grafting with supracondylar nailing is a viable option for this
pattern of fracture.