Background: The task force of ASBMR reported the concurrent evidences regarding atypical femoral fracture (AFF) in 2010. One of them is high incidence of delayed union or nonunion up to 26% after surgical fixation. However, a clinical report after surgical treatment of nonunion is still missing. The purpose of the study was to perform a retrospective study to review the clinical results of nonunion treatment in AFF.
Methods: Nonunion developed after surgical fixation for AFF in 15 patients (17 femora) and was treated by additional intervention(s) until union. Number of subtrochanteric fracture nonunion was 10 and shaft nonunion 7. We reviewed the medical records and radiographs of these patients and compared the results of subtrochanteric nonunion with shaft nonunion.
Results: All AFF nonunion was developed in female patients. Patients of the subtrochanteric nonunion group were younger than those of the shaft nonunion group. Femoral bowing was noted in the shaft fracture group only. Eleven out of 17 cases of AFF showed lateral cortical hypertrophy at the time of initial fracture. The effect of autogenous bone graft was acceptable in both groups. Average total numbers of operations were the same in both groups.
Conclusion: Even though the incidence of nonunion after atypical femoral fracture is high compared with other low-energy trauma, a proper treatment resulted in good clinical outcomes by single intervention in most of the cases. Healing speed of this nonunion was slow and it took a long time to be united.
Disclosure: The authors declared no competing interests.