Abstract:

Objective

To evaluate the clinical efficacy of a new assembly locking compression plate in the treatment of femoral nonunion after intramedullary nailing.

Methods

Twenty-two patients with nonunion following femoral intramedullary nailing surgery were divided into an observation group and a control group according to different treatment approaches.In the observation group, 11 cases were treated with the new assembly locking compression plate (NALCP) fixation, while 11 cases in the control group received treatment with the locking compression plate (LCP).The following parameters were recorded and compared: number of inserted screws, cortical fixation layers achieved by screws, intraoperative blood loss, fracture healing time,lower limb function scores (assessed at one, three, and six months postoperatively), visual analog scale (VAS)scores at one month after operation, final Hospital for Special Surgery (HSS) knee scores, and Harris hip scores(HHS) to evaluate clinical outcomes.Statistical analyses were performed as follows: comparisons across different time points between the two groups were analyzed using repeated measures ANOVA followed by Bonferroni post hoc test; comparisons of continuous data between groups was conducted by independen t test, while categorical data were assessed using Fisher’s exact test.

Results

Patients were followed up postoperatively at one, three,and six months, and one year.The observation group demonstrated a greater number of inserted screws (t=19.030,P<0.001) and cortical fixation layers achieved by screws (t=12.245, P<0.001) compared to the control group,with both differences reaching statistical significance.The observation group exhibited less intraoperative blood loss (t=-10.564, P<0.001) and shorter fracture healing time (t=-30.869, P<0.001) compared to the control group.Compared to the control group, the observation group showed higher lower limb function scores at one, three, and six months after operation (t=27.111, 61.968, 9.553, all P<0.001).The observation group exhibited lower VAS scores at one month after operation compared to the control group (t=-6.847, P<0.001).No statistically significant differences were observed between the two groups in the final HSS knee scores or HHS (t=1.580, 0.830, all P>0.05).

Conclusions

Compared to LCP, NALCP as an adjunctive fixation for femoral nonunion following intramedullary nailing demonstrates superior clinical efficacy.By retaining the original intramedullary nail, NALCP provides enhanced fracture stability through multi-dimensional fixation while preserving local blood supply due to its anatomical design.This approach minimizes surgical trauma,accelerates fracture union, improves lower limb functional recovery, reduces early postoperative pain, and enhances patients’ quality of life.

Key words: Fractures, ununited, Femoral fractures, Fracture fixation, intramedullary, Bone plates