Dual locking plate fixation, PRP-augmented autologous bone grafting, and bioactive core construction for femoral fracture nonunion: a retrospective study of 52 cases

Dual locking plate fixation, PRP-augmented autologous bone grafting, and bioactive core construction for femoral fracture nonunion: a retrospective study of 52 cases

BackgroundFemoral nonunion remains a challenging orthopedic condition. This study evaluates a combined protocol integrating biomechanical stabilization (dual locking plate fixation) and maximal biological stimulation (PRP-augmented autologous bone grafting with bioactive core construction) to optimi...

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Main Authors: Zhihao Peng, Shiheng Wang, Ke Jie, Yonghong Dai, Kunyu Wang, Jiahua Wu, Feng Wu, Jianrong Chen
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Medicine
Subjects:
fracture nonunion
femoral fracture nonunion
platelet-rich plasma
autologous iliac bone grafting
dual plate fixation
Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1615628/full
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Summary:BackgroundFemoral nonunion remains a challenging orthopedic condition. This study evaluates a combined protocol integrating biomechanical stabilization (dual locking plate fixation) and maximal biological stimulation (PRP-augmented autologous bone grafting with bioactive core construction) to optimize bone healing.MethodsA retrospective analysis included 52 femoral nonunion patients treated at a tertiary trauma center (2020–2024). Outcomes assessed radiographic union (9-month and final follow-up), clinical union time, thigh incision healing, pain scores (VAS), lower extremity function (LEFS), and complications.ResultsCohort demographics: 35 males, 17 females; mean age 41.38 years, BMI 24.79 kg/m2. Nonunion subtypes: hypertrophic (36.5%, n = 19), atrophic (50%, n = 26), oligotrophic (13.5%, n = 7); locations: femoral shaft (63.5%, n = 33), supracondylar (36.5%, n = 19). All achieved union (mean follow-up: 19.01 months) with mean union time 6.56 ± 1.04 months. Postoperative outcomes: pain score 0.63 ± 0.97, LEFS 63.92 ± 5.92, incision healing 12.13 ± 1.36 days. The incidence rate of serious complications was 3.85% (2/52).ConclusionThe protocol demonstrated efficacy and safety, achieving rapid union (6.56 months), robust functional recovery (LEFS 63.92), and a low incidence of serious complications (3.85%). Biomechanical-biological integration represents a viable strategy for femoral nonunion management.
ISSN:2296-858X

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