Femoral shaft nonunions

Summary

Age, gender, fracture type, nail locking technique, and bone grafting did not appear to affect union, mean time to union, or need for additional procedures. Evidence on smoking as a prognostic factor was conflicting. Nonsmokers were more likely to achieve union after one procedure compared with smokers in one study. However, the mean time to union and need for additional procedures were not decreased in nonsmokers in two other studies. Studies may have had insufficient power to detect the effects of various prognostic factors. A methodologically rigorous multi-center prognostic study may provide a larger sample size, and help delineate factors affecting outcome in exchange nailing for the treatment of femoral shaft nonunion.