Nonunion of femoral fractures has continued to challenge orthopaedic surgeons. Interlocking nailing with reaming offers the advantages of stable fixation. adequate alignment, minimum shortening, good rotational control, early weight bearing without external support and high union rate.

Between August 1988 and March 1993, 20 patients with nonunion of the femoral fractures were treated by an interlocking nailing with reaming. The types of primary treatment prior to nonunion were plate fixation in 10 patients, conventional intramedullary nailing in 9 patients and external fixation in 1 patient.

The purpose of this study was to evaluate the causes of nonunion and analyze the results with interlocking nailing in the management of nonunion of femoral fractures. The radiological examination revealed that formation of the bridge callus took a mean of 3.5 months for the patients who received the plate and screw fixation. On the other hand. it took a mean of 2.4 months for the patients who were treated with conventional intramedullary nailing. When the two groups of patients were combined, it took a mean of 3.2 months. All patients were obtained the complete union in a mean time of 10.4 months after an interlocking nailing. Complications were 1 breakage of distal target screws. 1 pain near the entry of nail and 1 delayed union. Limb shortening was measured by roentgenoscanography and occurred in all patients but not clinically significant.