DOI: 10.36347/sjams.2020.v08i06.029

Pages: 1539-1558

Femoral shaft non-union is a functional and economical challenge for the patient as well as a treatment dilemma for the surgeon. The Association for Osteo-synthesis (AO)’ as a means of preventing the development of fracture disease and early recovery. Intramedullary (IM) nailing is the gold standard for the management of femoral shaft fractures. To find out the Functional outcome in exchange nailing with autogenous cancellous bone graft for aseptic nonunion of femoral shaft. From July 2015 to June 2017, more than 30 patients of femoral shaft aseptic nonunion were treated with this technique at Pabna Medical College Hospital and clinics in Pabna, Bangladesh. 21 patients were finally recorded for study. Among them 1(one) patient was lost after 04 weeks before fracture healing. Culture of the 1st reaming materials revealed growth in 2 cases. So, final outcome, analysis and test of significance were done with 18 patients. Mean age 41.95 Years; SD ± 13.11; Male: Female = 3.3:1 Among 18 fractures nonunion, 15 fractures (83.33%) were united and 3 fractures (16.67%) were not united after exchange nailing with autogenous bone graft in aseptic condition. Confidence Interval at 95% level 66.08%-100%. Mean union time was 26.00 ±4.5 weeks where 95% confidence interval was 23.49±28.51weeks including both static and dynamic mode of fixation. In static mode mean union time were 29.33±3.01 weeks whereas in early dynamic it was 21.33±1.63 weeks. It was also calculated that after late dynamization mean union time was 28.67±2.309 weeks. Among complications unacceptable Angle deviation 5.6%, Limb length discrepancy 5.6%, Pain –Swelling 5.6%, Infection 11.12%, Joint motion restriction 5.6%, Implant failure 5.6%. There was a strongly positive correlation between age and union time; that means more the age more the union time. In this study, it was found that smoking and NSAIDs both had significant relation (p<0.05) with fracture union time. Highly strong (+) ve correlation.............