Distal femur nonunion treated with retrograde intramedullary nailing and RIA: a case report

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Francesco Pogliacomi
Carlotta Artoni
Filippo Calderazzi
Massimiliano Leigheb
Paolo Primiceri
Alessio Pedrazzini
Francesco Ceccarelli
Enrico Vaienti


distal femur, fracture, nonunion, fixation, plating, nailing


The current treatment of distal femur fractures includes locking plating and retrograde intramedullary
nailing. These fractures are difficult to manage also for experienced surgeons, with results not always
satisfactory. Reported nonunion rates now range from 0 to 34%. Factors associated with nonunion include
comorbidities, such as obesity and diabetes, as well as the presence of open fractures, medial bone defects
and comminuted fractures. This case report summarizes all of these assumptions and it concerns a 58 years
old patient who underwent to 6 surgical procedures before to arrive to bone healing.


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