Use of Additional Locking Plate-derived Poller Screws for Treatment of Femoral Non-union after Intramedullary Nailing.

Objective: To evaluate the efficacy of using additional locking plate-derived Poller screws to treat post-intramedullary nailing for femoral non-union was investigated. Methods: Between January 2009 and April 2012, six patients who underwent post-intramedullary nailing for femoral non-union were studied. Three, one, and two patients had femoral fractures in the proximal one-third, middle third and distal third, respectively. While the original intramedullary nails were retained, eight-to-nine hole locking plates were used for fixation and two-to-three cortical bone screws were applied to both sides of the fracture to ensure the stability of the intramedullary nail sagittal plane. One-to-two pieces of locking nails were inserted tightly next to the intramedullary nails to ensure a stable coronal plane. Autologous iliac bone grafts were performed around the fractures in all cases. Results: Follow-up evaluations were conducted between 10 and 17 months (mean, 13.8 months). The operative time was 110-160 minutes and the blood loss was 300-500 mL. Bone pain was relieved in 1 month. Continuous callus was observed after 4-6 months (mean, 4.83 months) based on imaging. There were no infections, loosening of internal fixation, or rupture. All patients were able to walk bearing weight within 3 months. Conclusion: An additional locking plate and the derived Poller screw technique effectively improved local rotation instability and is an effective and simple treatment method for femoral non-union after intramedullary nailing. [ABSTRACT FROM AUTHOR]