Impaction bone grafting of segmental bone defects in femoral non-unions

Impaction bone grafting shows encouraging early results as a method of immediately restoring leg length, while allowing weight-bearing as tolerated, in the treatment of large segmental femoral defects after femoral shaft and metaphyseal non-unions. The operative technique followed is described in three consecutive cases and the effectiveness of impaction bone grafting for femoral non-unions with associated large segmental bone defects has been demonstrated. Between 80 and 120 cm³ of coarsely milled irradiated bone allograft was used to reconstruct the defects, which were contained in malleable metal mesh. All three patients were fully weight-bearing by three months postoperatively. At two years follow-up, plain radiographs demonstrated maintenance of reduction and healing in all three cases.