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Nonunion and shortening after femoral fracture treated with one-stage lengthening using locked nailing technique. Good results in 48/51 patients.

We report on 56 consecutive aseptic femoral shaft nonunions with shortening, which were treated with local debridement, skeletal traction, a spine-spreader aiding lengthening, static locked nail stabilization and corticocancellous bone grafting. 51 patients were followed for 2 (1-4) years and 48 achieved a solid union. The median period to bony union was 4 (3-8) months and lengthening achieved was 2.8 (1.5-4.5) cm. 3 patients had nonunion, 2 without implant failure and 1 with implant failure. However, all 3 healed after reoperation. There was no neurovascular injury or deep infection.