Objective: To evaluate the functional and radiological outcomes of long bone fractures in non-union cases treated with nail and plate with osteo-periosteal flaps.
Methods: This prospective study included 20 patients with non-union long bone fractures treated at Dr. DY Patil Medical College, Pimpri, Pune over a two-year period. Patients underwent surgical intervention using nail and plate with osteo-periosteal flaps. Outcomes were assessed using the Non-Union Scoring System (NUSS), Radiographic Union Scale in Tibial Fracture (RUST), and Lower Extremity Functional Scale (LEFS) at regular intervals over one year. Time to union and complications were also recorded.
Results: The mean age of patients was 41.5 ± 7.1 years, with 60% being male. Femur fractures were most common (40%), followed by tibia (35%) and humerus (25%). The mean duration of non-union before treatment was 4.15 ± 1.7 months. The average time to union was 19.8 ± 3.9 weeks. NUSS scores decreased from 40.9 ± 8.06 at one week to 16.6 ± 8.2 at one year. RUST scores improved from 4.0 ± 0 to 11.3 ± 0.92, and LEFS scores increased from 9.6 ± 1.9 to 69.2 ± 5.1 over the same period. Complications occurred in 40% of cases, with surgical site infection being the most common (20%).
Conclusion: The use of nail and plate with osteo-periosteal flaps for non-union long bone fractures demonstrated improvements in both functional and radiological outcomes over a one-year follow-up period. However, careful monitoring for complications is necessary. Further studies with larger sample sizes are recommended to confirm these findings.
Keywords: bone graft; bone nails; bone plates; fracture healing; fractures; non-union; osteo-periosteal flaps.
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