{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T20:58:08Z","timestamp":1770152288461,"version":"3.49.0"},"reference-count":35,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,11,21]],"date-time":"2022-11-21T00:00:00Z","timestamp":1668988800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Aseptic femoral shaft nonunion constitutes approximately 1%\u201310% of all femoral shaft fractures treated with intramedullary nail (IMN) fixation, possibly attributable to the lack of anti\u2010rotational stability. Although a lateral locking plate (LP) with retainment of original IMN has shown the most success, lateral LP inflicts significant surgical trauma on patients. Therefore, the Multidimensional Cross Locking Plate (MDC\u2010LP) was designed based on a mini\u2010open femoral anterior approach. We aim to report and compare the technical aspects and clinical outcomes of using anterior MDC\u2010LP or lateral LP with retention of original IMN for the treatment of aseptic femoral shaft nonunion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this single center retrospective cohort study, records of 49 patients who had undergone revision of femoral shaft aseptic nonunion with anterior MDC\u2010LP or lateral LP while retaining the original IMN from January 2015 to October 2019 were retrospectively reviewed. Information on patients' demographics, clinical data, and surgical outcomes were gathered and analyzed. X\u2010ray and CT scans were used for bone union evaluation and the lower extremity functional scale (LEFS) was used for follow\u2010up functional evaluation. For quantitative data, the Student's <jats:italic>t<\/jats:italic>\u2010test was used if the data were normally distributed. The Mann\u2013Whitney <jats:italic>U<\/jats:italic>\u2010test was used for non\u2010normally distributed data. For qualitative data, the Chi\u2010square test was used for comparisons.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010seven patients were treated with anterior MDC\u2010LP, and 22 patients were treated with lateral LP. There are no significant differences in age, sex, BMI, time since initial femoral shaft fracture, initial fracture type (close\/open), nonunion type, or nonunion location between patients' group. Among patients treated with anterior MDC\u2010LP, an average of 2\u2010months advantage in time to union was observed (4.09\u00a0months <jats:italic>vs.<\/jats:italic> 6.8\u2009months in the lateral LP group: <jats:italic>P<\/jats:italic>\u00a0=\u00a00.000), smaller incision was required for MDC\u2010LP installment (7.7\u2009cm <jats:italic>vs<\/jats:italic> 17.1\u2009cm in lateral LP group: <jats:italic>P<\/jats:italic>\u00a0=\u00a00.000).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>For the treatment of aseptic femoral shaft nonunion with retainment of original IMN, anterior MDC\u2010LP <jats:italic>via<\/jats:italic> mini\u2010open femoral anterior approach described in this study is a better option than lateral LP for achieving faster bone union and satisfactory functional outcome with less surgical trauma.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.13581","type":"journal-article","created":{"date-parts":[[2022,11,22]],"date-time":"2022-11-22T05:00:05Z","timestamp":1669093205000},"page":"169-178","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Augmented Stability in Leaving Original Internal Fixation with Multidimensional Cross Locking Plate through Mini\u2010Open Femoral Anterior Approach for Aseptic Femoral Shaft Nonunion: A Retrospective Cohort Study"],"prefix":"10.1111","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4625-1038","authenticated-orcid":false,"given":"Taoguang","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery the fourth medical center, Chinese PLA General hospital  Beijing 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Orthopedic Surgery the fourth medical center, Chinese PLA General hospital  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peifu","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery the fourth medical center, Chinese PLA General hospital  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4410-6742","authenticated-orcid":false,"given":"Hua","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery the fourth medical center, Chinese PLA General hospital  Beijing 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