Transverse Fractures

Posted by on Aug 17, 2016 | Comments Off on Transverse Fractures

The most common fracture resulting in nonunion is a transverse fracture, midshaft femur. Why?

  1. Transverse fractures are created by tension and therefore the cortical stem cells are not mechanically stimulated to form bone.
  2. Strain or magnitude of deformity is concentrated in a small area of the fracture as opposed to a comminuted fracture.

We must therefore place the largest diameter and length nail possible to stabilize the fracture. In fractures of the distal femur, we must place the nail retrograde. If a nonunion develops and the nail appears to be large enough, adding a plate to decrease shear often results in healing. Bone grafting using bone from the flutes of the reamer must be placed at this fracture site.

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