When should we start Weight bearing in a Young patient diagnosed as Nonunion of the shaft of Femur fracture of an unknown cause?
Previously, ORIF with Plating was applied. Now, the same Plate was continued because of the reason that the fracture was stable and the alignment was acceptable. And, finally Bone Autografting was done from the Iliac bone.
So, my First question is, Can we continue the same Plate?
And my Second question is, If Yes, when should the weight bearing be started?
Dear Ashok
The RX shows an avascular nonunion. Probably the work length of the bridge plate is short, the density screws is more than 50% and there is little movement with stress concentration on the fracture gap. An alternative is replace this plate for another one, with 3 screws in each side, like wave plate (to diminish the concentration stress) and bone graft under the wave or change for reamed intramedullary nail. There is a possibility of failure of this plate with weight bearing
Dear Nelson,
The wave - plate seems to be a good alternative.
Since we opted to continue the same plate with an autograft, I am curious to know, If there is a possibility of failure of this plate with weight bearing, how long should the weight bearing be delayed ?? Can the weight bearing be started if there is a visible callus formation in the X-ray ??
Thank you.
Yes. The weight bearing can be started with crutches and the LCP is a plate with angular stability and acts an internal fixator.