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Nonunions of fractures of the proximal and distal thirds of the shaft of the femur.

Subtrochanteric and supracondylar fractures of the femur are challenging, and specific anatomic and mechanical problems make fixation precarious. With careful selection of devices and techniques, nonunions may be avoided. Nonunion treatment requires strong immobilization and osteogenesis stimulation with bone grafts. Non-invasive and semi-invasive salvage systems are not as effective as invasive procedures. The first goal of salvage is union. Joint function and muscle strength are secondary goals to be achieved later.