Is the Wave Plate Still a Salvage Procedure for Femoral Non-union? Results of 75 Cases Treated with a Locked Wave Plate

Arndt P Schulz; Maximilian Faschingbauer; Klaus Seide; Uwe Schuemann; Martin Mayer; Christian Jürgens; Michael Wenzl

doi:10.1007/s00068-008-8009-9

Is the Wave Plate Still a Salvage Procedure for Femoral Non-union? Results of 75 Cases Treated with a Locked Wave Plate

Eur J Trauma Emerg Surg. 2009 Apr;35(2):127-31. doi: 10.1007/s00068-008-8009-9. Epub 2008 Jul 25.

Authors

Arndt P Schulz^{1

2

3}, Maximilian Faschingbauer⁴, Klaus Seide⁴, Uwe Schuemann⁴, Martin Mayer⁵, Christian Jürgens^{6

4}, Michael Wenzl⁴

Affiliations

¹ BG Trauma Hospital Hamburg, Trauma and Reconstructive Surgery, Hamburg, Germany. [email protected].
² Department of Musculoskeletal Surgery, University Hospital Lübeck, Lübeck, Germany. [email protected].
³ BG Trauma Hospital, Hamburg Trauma and Reconstructive Surgery, Bergedorfer Strasse 10, 21027, Hamburg, Germany. [email protected].
⁴ Department of Musculoskeletal Surgery, University Hospital Lübeck, Lübeck, Germany.
⁵ Medical Faculty, University Hospital Lübeck, Lübeck, Germany.
⁶ BG Trauma Hospital Hamburg, Trauma and Reconstructive Surgery, Hamburg, Germany.

PMID: 26814765
DOI: 10.1007/s00068-008-8009-9

Abstract

Objective: To analyse the results of the treatment of aseptic femoral non-unions using a singular locked implant.

Design: Consecutive case series.

Setting: A level-1 trauma center with a high number of specialist referrals.

Patients: The study is based on a consecutive series of patients with prospective data evaluation. From 1993 to 2003, 75 patients were treated with a wave plate. All patients had persistent non-union of the femoral shaft without clinical or laboratory signs of infection and previous unsuccessful attempts to treat the non-union.

Intervention: The method of treatment was standardized and included a lateral approach, cancellous bone hip grafting, osteosynthesis with a wave-shaped plate (PPF) and polyaxial locking screws as well as the application of a gentamicin-PMMA chain.

Main outcome measurements: Time to achieve union, rate of implant failure and number of remaining nonunions after treatment. A total of 75 patients had full follow-up and were included in the study.

Results: The union of the fracture was found in 64 patients after the initial procedure. In eight cases a second procedure was performed to achieve union in the form of a second bone graft because of a delay in callus formation. The mean time to union was 7.3 months with a range from 3 to 19 months. The implant failed in three cases accounting for 4% of the total.

Conclusion: The locked wave plate offers a further reliable treatment for complex aseptic femoral non-unions.

Keywords: Femoral fractures; Intramedullary nailing of long bones; Locked plate; Non-union; Proximal femoral and femoral shaft fractures; Psaeudoarthrosis; Revision surgery.