Dr. Mahendra Kumar Swami


Background: Incidence of distal femur fractures is approximately 37/ one lakh person-years. Distal femoral fractures mainly arise from two different injury mechanisms by high energy trauma and low energy trauma.


Objective: To find out the causes of Non Union of distal femur and progress of such nonunion.

 Methodology: Total 35 cases of distal femur fracture nonunion satisfying inclusion and exclusion criteria treated and followed up from May 2016 to September 2018 are taken in the study and all patients were followed up according to post-operative follow up protocol.


Results: Among the 35 cases 31 were male and 04 were female. The mean age of case presenting to us at the detection of Non Union was 38.5 years. Symmetrical distribution of cases in the age group from 20-49 years which accounted for 29 cases (82.85%). Right limb was involved in more number of cases. Accidents were noted to be the main cause of primary fractures. Most of the cases had a compound injury initially. Aseptic Non Union was seen in 60% and infected Non Union in 40% of cases. The most common cause of non-union was found to be infection


Conclusion: Commonest cause of non-union was found to be infection and most common injury associated was found to be Ipsilateral lower limb injuries


Non-union, distal femur, Road traffic accident, domestic fall

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Zlowodzki M, Williamson S, Cole PA, Zardiackas LD, Kregor PJ. Biomechanical evaluation of the less invasive stabilization system, angled blade plate, and retrograde intramedullary nail for the internal fixation of distal femur fractures. Journal of orthopaedic trauma. 2004; 18(8):494-502.

Esterhai JL, Jr. Brighton CT, Heppenstall RB, Alavi A, Desai AG. Detection of synovial pseudarthrosis by 99mTc scintigraphy: application to treatment of traumatic nonunion with constant direct current. Clinical orthopaedics and related research. 1981; (161):15-23.

Ebraheim NA, Martin A, Sochacki KR, Liu J. Nonunion of distal femoral fractures: a systematic review. Orthopaedic surgery. 2013; 5(1):46-50.

Bellabarba C, Ricci WM, Bolhofner BR. Indirect reduction and plating of distal femoral nonunions. Journal of orthopaedic trauma. 2002; 16(5):287-96.

Chapman MW, Finkemeier CG. Treatment of supracondylar nonunions of the femur with plate fixation and bone graft. The Journal of bone and joint surgery American volume. 1999; 81(9):1217-28.

Prasarn ML, Ahn J, Achor T, Matuszewski P, Lorich DG, Helfet DL. Management of infected femoral nonunions with a single-staged protocol utilizing internal fixation. Injury. 2009; 40(11):1220-5.

Wang JW, Weng LH. Treatment of distal femoral nonunion with internal fixation, cortical allograft struts, and autogenous bone-grafting. The Journal of bone and joint surgery American volume. 2003; 85-A(3):436-40.

Gardner MJ, Toro-Arbelaez JB, Harrison M, Hierholzer C, Lorich DG, Helfet DL. Open reduction and internal fixation of distal femoral nonunions: long-term functional outcomes following a treatment protocol. The Journal of trauma. 2008; 64(2):434-8

Thonse R, Conway J. Antibiotic cement-coated interlocking nail for the treatment of infected nonunions and segmental bone defects. Journal of orthopaedic trauma. 2007; 21(4):258-68.

Babhulkar S, Pande K, Babhulkar S. Nonunion of the diaphysis of long bones. Clinical orthopaedics and related research. 2005; (431):50-6.

Shahcheraghi GH, Bayatpoor A. Infected tibial nonunion. Canadian journal of surgery Journal canadien de chirurgie. 1994; 37(3):209-13.

Shyam AK, Sancheti PK, Patel SK, Rocha S, Pradhan C, Patil A. Use of antibiotic cement-impregnated intramedullary nail in treatment of infected non-union of long bones. Indian journal of orthopaedics. 2009; 43(4):396-402


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