{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T13:19:35Z","timestamp":1794057575783,"version":"4.8.0"},"reference-count":16,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,4,7]],"date-time":"2025-04-07T00:00:00Z","timestamp":1743984000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Femoral nonunion after intramedullary nailing (IMN) of a diaphyseal long bone fracture is a severe complication that requires effective management. The IMN dynamization has been used to treat hypertrophic nonunions previously. However, routine nail dynamization has only a low success rate and the risk of limb shortening.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Two patients with femoral shaft fracture hypertrophic nonunion at 4 or 5 months after intramedullary nailing were treated with the therapeutic paradigm named \u201ccontrolled nail dynamization\u201d. In this paradigm, the interlocking nails are removed but the dynamic hole nails are retained. At the same time, four Poller screws were used to limit the movement of the intramedullary nail in the coronal and sagittal planes. The intramedullary nail can only generate compressive stress along the axial direction of the femoral shaft, thereby promoting fracture healing. So this technique was named \u201ccontrolled nail dynamization\u201d.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Here, we describe two cases of delayed healing of the femoral diaphysis, which were successfully treated through controlled nail dynamization. Followed up for more than 12 months. Bone union was achieved in both patients, and there were no complications such as nonunion and internal fixation failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The controlled nail dynamization is feasible for safe and effective treatment for femoral shaft hypertrophic nonunion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2025.1547793","type":"journal-article","created":{"date-parts":[[2025,4,7]],"date-time":"2025-04-07T01:16:49Z","timestamp":1743988609000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Use of controlled nail dynamization technique for femoral shaft hypertrophic nonunion"],"prefix":"10.3389","volume":"12","author":[{"given":"Qian","family":"Wu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"XueCheng","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gang","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,4,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1038\/s41572-021-00289-8","article-title":"Non-union bone fractures","volume":"7","author":"Wildemann","year":"2021","journal-title":"Nat Rev Dis Primers"},{"key":"B2","doi-asserted-by":"publisher","first-page":"394","DOI":"10.1097\/00005131-200207000-00005","article-title":"The treatment of nonunions following intramedullary nailing of femoral shaft fractures","volume":"16","author":"Pihlajamaki","year":"2002","journal-title":"J Orthop Trauma"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1355","DOI":"10.1007\/s00264-021-04973-y","article-title":"The history of intramedullary nailing","volume":"45","author":"Bekos","year":"2021","journal-title":"Int Orthop"},{"key":"B4","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1007\/s00264-017-3734-5","article-title":"Diaphyseal long bone nonunions\u2014types, aetiology, economics, and treatment recommendations","volume":"42","author":"Rupp","year":"2018","journal-title":"Int Orthop"},{"key":"B5","doi-asserted-by":"publisher","first-page":"464","DOI":"10.1097\/00005131-199809000-00006","article-title":"Retrograde intramedullary nailing of femoral diaphyseal fractures","volume":"12","author":"Ostrum","year":"1998","journal-title":"J Orthop Trauma"},{"key":"B6","first-page":"42","article-title":"Histomorphometric analysis of the normal adult patella","volume":"67","author":"Sabo","year":"2001","journal-title":"Acta Orthop Belg"},{"key":"B7","doi-asserted-by":"publisher","first-page":"322","DOI":"10.1016\/j.jcot.2017.12.007","article-title":"Is nail dynamization beneficial after twelve weeks\u2014an analysis of 37 cases","volume":"9","author":"Perumal","year":"2018","journal-title":"J Clin Orthop Trauma"},{"key":"B8","doi-asserted-by":"publisher","first-page":"709","DOI":"10.2106\/00004623-198567050-00005","article-title":"Closed locked intramedullary nailing. Its application to comminuted fractures of the femur","volume":"67","author":"Kempf","year":"1985","journal-title":"J Bone Joint Surg Am"},{"key":"B9","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1097\/00005373-199708000-00010","article-title":"The effect of dynamization on slowing the healing of femur shaft fractures after interlocking nailing","volume":"43","author":"Wu","year":"1997","journal-title":"J Trauma"},{"key":"B10","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1007\/s11751-009-0065-0","article-title":"Reamed interlocking intramedullary nailing for the treatment of tibial diaphyseal fractures and aseptic nonunions. Can we expect an optimum result?","volume":"4","author":"Chalidis","year":"2009","journal-title":"Strategies Trauma Limb Reconstr"},{"key":"B11","doi-asserted-by":"publisher","first-page":"88","DOI":"10.5435\/00124635-200802000-00006","article-title":"Femoral nonunion: risk factors and treatment options","volume":"16","author":"Lynch","year":"2008","journal-title":"J Am Acad Orthop Surg"},{"key":"B12","doi-asserted-by":"publisher","first-page":"S30","DOI":"10.1016\/j.injury.2005.10.008","article-title":"Classification of non-union","volume":"36","author":"Megas","year":"2005","journal-title":"Injury"},{"key":"B13","doi-asserted-by":"publisher","first-page":"S23","DOI":"10.1097\/BOT.0000000000000905","article-title":"Exchange nailing for hypertrophic femoral nonunion","volume":"31","author":"Marquez-Lara","year":"2017","journal-title":"J Orthop Trauma"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1747","DOI":"10.1016\/j.injury.2012.06.024","article-title":"Evaluation of methods and timing in nail dynamisation for treating delayed healing femoral shaft fractures","volume":"43","author":"Huang","year":"2012","journal-title":"Injury"},{"key":"B15","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1007\/s00264-018-4129-y","article-title":"The ideal timing for nail dynamization in femoral shaft delayed union and non-union","volume":"43","author":"Vicenti","year":"2019","journal-title":"Int Orthop"},{"key":"B16","doi-asserted-by":"publisher","first-page":"557","DOI":"10.3389\/fbioe.2020.00557","article-title":"Mechanical behavior of elastic self-locking nails for intramedullary fracture fixation: a numerical analysis of innovative nail designs","volume":"8","author":"Putame","year":"2020","journal-title":"Front Bioeng Biotechnol"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2025.1547793\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,7]],"date-time":"2025-04-07T01:17:04Z","timestamp":1743988624000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2025.1547793\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,7]]},"references-count":16,"alternative-id":["10.3389\/fsurg.2025.1547793"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2025.1547793","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,7]]},"article-number":"1547793"}}