Retaining intramedullary nail with plate fixation outperforms nail removal and double-plate fixation in femoral shaft nonunion

The method of retaining the original intramedullary nail using hybrid bone grafting combined with local augmented plate fixation had a shorter operation time, less total blood loss, lower VAS scores, and shorter union time compared to the method of removing the original intramedullary nail, performing channel bone grafting, and using vertical double-plate fixation. In clinical practice, the treatment method of retaining the original intramedullary nail using hybrid bone grafting combined with local augmented plate fixation may be a more preferable treatment option for atrophic nonunion of femoral shaft after intramedullary nailing.