The use of bone substitutes in treating large bone defects after femoral shaft fractures – case report

Abstract

The femoral shaft fractures are one of the most frequent and serious traumatic disorders encountered in orthopaedic practice. Some of them have large bone defects that complicate the treatment and often result in nonunion. The use of bone substitutes for the treatment of bone defects is an effective and low-risk method. The patient is a 26 years old male, nonsmoker, professional soccer player, victim of a motorvehicle accident (driver) that resulted in politrauma (multiple rib fractures, thoracic contusion, head injury, open complex left femoral shaft fracture Gustilo-Anderson type II, AO type C3, Winquist-Hansen grade IV). The femoral fracture is surgically treated (close reduction and internal fixation using an intramedullary unreamed nail, statically locked). 12 months after the surgical intervention the fracture hasn’t healed, and an atrophic nonunion developed. The surgical treatment of the nonunion is performed 13 months after the first surgical intervention. It consists in opening the nonunion site, resecting the bone ends and applying a calcium-phosphate based bone substitute. The postoperative evolution is good and the patient restarts the athletic activity three years after the intervention.

Key words:

femoral shaft fracture, bone defect, bone substitute