• Yoshinobu Watanabe and Takashi Matsushita.
• Department of Orthopaedic Surgery, Teikyo University School of Medicine, Tokyo, Japan. Electronic address: fracture@zad.att.ne.jp.
• Injury. 2016 Dec 1; 47 Suppl 6: S47-S52.

IntroductionThe purpose of this study was to investigate the effectiveness of the chipping technique for the treatment of femoral non-unions associated with malalignment.Patients And MethodsA total of 21 femoral non-unions were managed with the chipping procedure and re-fixation. 15 of them had malalignment (angular or rotational deformity or limb length discrepancy). The deformities were simultaneously corrected by a combination of chipping and temporal external fixator. The median age of patients were 41 years (range, 19-73 years). The median time from injury or the final surgery to the initial chipping procedure was 24 months (range: 9-240 months). Femoral non-unions were classified as hypertrophic in 9, oligotrophic in 5 and atrophic in 7. Clinical and radiological assessment was performed.ResultsAll femoral non-unions radiographically healed with one (19 cases) or two (2 cases) chipping procedures without bone grafting. Pre-existing angular deformity was corrected from 14° to 2°, external rotation 27° to 0°, and limb length discrepancy 16-7 mm. There were no major complications, although swelling of thigh and anemia was common after surgery.ConclusionChipping the non-union site was associated with a favorable outcome. It biologically enhances fracture healing and should be considered as a treatment option for femoral non-unions with malalignment.Copyright © 2016 Elsevier Ltd. All rights reserved.

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