{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T01:01:32Z","timestamp":1780966892549,"version":"3.54.1"},"reference-count":42,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2022,12,14]],"date-time":"2022-12-14T00:00:00Z","timestamp":1670976000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Pseudarthrosis (PSA) is a possible complication of femoral shaft fracture treatment. It is often associated with reduced bone quality and can, therefore, adversely affect quality of life. Its treatment poses a major challenge for orthopaedic surgeons. Several authors have set forth different surgical approaches for the treatment of pseudarthrosis, such as internal fixation with plate and screws, replacement of an intramedullary nail or prosthetic replacement. In cases associated with bone loss, osteopenia, or comminution of fracture fragments, autologous or homologous bone grafts may also be used. The chronic outcomes of the surgical treatment of femoral shaft pseudarthrosis, even when consolidation is achieved, are linked to disabling sequelae of clinical-functional relevance, deserving an adequate medico-legal evaluation. The purpose of this retrospective study is to analyse a clinical case series of patients treated for atrophic femoral shaft pseudarthrosis at the IRCCS Orthopaedic Institute Galeazzi, Milan, Italy, from 2014 to 2020 and their orthopaedic-traumatological and medico-legal implications.<\/jats:p>","DOI":"10.3390\/jcm11247407","type":"journal-article","created":{"date-parts":[[2022,12,14]],"date-time":"2022-12-14T04:54:49Z","timestamp":1670993689000},"page":"7407","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Treatment of Femoral Shaft Pseudarthrosis, Case Series and Medico-Legal Implications"],"prefix":"10.3390","volume":"11","author":[{"given":"Giuseppe","family":"Basile","sequence":"first","affiliation":[{"name":"IRCCS Orthopedic Institute Galeazzi, 20161 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6368-2614","authenticated-orcid":false,"given":"Stefania","family":"Fozzato","sequence":"additional","affiliation":[{"name":"IRCCS Orthopedic Institute Galeazzi, 20161 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quirino Alessandro","family":"Petrucci","sequence":"additional","affiliation":[{"name":"Department of Anatomical, Histological, Forensic and Orthopedic Sciences, \u201cSapienza\u201d University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Gallina","sequence":"additional","affiliation":[{"name":"IRCCS Orthopedic Institute Galeazzi, 20161 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Bianco Prevot","sequence":"additional","affiliation":[{"name":"IRCCS Orthopedic Institute Galeazzi, 20161 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Accetta","sequence":"additional","affiliation":[{"name":"IRCCS Orthopedic Institute Galeazzi, 20161 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5741-7139","authenticated-orcid":false,"given":"Simona","family":"Zaami","sequence":"additional","affiliation":[{"name":"Department of Anatomical, Histological, Forensic and Orthopedic Sciences, \u201cSapienza\u201d University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,14]]},"reference":[{"key":"ref_1","first-page":"e2022176","article-title":"Atrophic Pseudarthrosis of Humeral Diaphyseal Fractures: Medico-Legal Implications and Methodological Analysis of the Evaluation","volume":"93","author":"Basile","year":"2022","journal-title":"Acta Biomed."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1007\/s00068-007-6195-5","article-title":"Current Concepts: Aseptic Nonunion of Femoral Shaft Diaphysis","volume":"33","author":"Lambiris","year":"2007","journal-title":"Eur. 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