evaluation of treatment outcomes for femoral shaft nonunion fixed with intramedullary nail, with addition of plate and bone graft

Introduction:femoral shaft nonunion is a serious and challenging complication following intramedullary nailing requiring effective interventions to achieve successful bone union.materials and methods:in this retrospective cross-sectional study, 20 patients with femoral shaft nonunion previously treated with intramedullary nailing underwent revision surgery with augmentation plating and bone grafting.results:the mean age of patients was 42.5 years, and 90% achieved complete bone union. the average union time was 16.2 weeks. factors influencing outcomes included age, underlying diseases, fracture type, and the time to revision surgery. compared to a historical control group treated with revision nailing alone, this study showed significantly reduced healing time and improved function. limited complications included superficial infections managed conservatively.conclusion:the findings highlight augmentation plating and bone grafting as an effective and reliable approach for treating femoral shaft nonunion after intramedullary nailing. future prospective studies with larger samples and long-term follow-up are recommended to assess treatment durability and possible complications. additionally, investigating factors affecting recovery and quality of life could improve treatment protocols.