{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T12:58:30Z","timestamp":1777381110301,"version":"3.51.4"},"reference-count":38,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,4,10]],"date-time":"2023-04-10T00:00:00Z","timestamp":1681084800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"the department of Orthopaedics"},{"name":"Royal Perth Hospital"},{"name":"University of Western Australia"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Background: Non-unions after intramedullary nailing of femoral shaft fractures are a significant problem. Treatment options such as augmenting with plates or exchange nailing have been proposed. The ideal treatment remains controversial. Methods: Augmentative plating using a 4.5 mm LCP or a 3.2 mm LCP leaving the nail in situ was tested biomechanically and compared to exchange intramedullary nailing in a SawboneTM model of a femoral shaft non-union. Results: The difference of fracture gap motion in axial testing was small. In rotational testing, the exchange nail allowed for the largest amount of motion. The 4.5 mm augmentative plate was the most stable construct in all loading conditions. Conclusions: Augmentative plating using a 4.5 mm LCP plate while leaving the nail in situ is biomechanically superior to exchange intramedullary nailing. A small fragment 3.2 mm LCP is undersized and does not reduce fracture motion sufficiently in a femoral shaft non-union.<\/jats:p>","DOI":"10.3390\/jpm13040650","type":"journal-article","created":{"date-parts":[[2023,4,10]],"date-time":"2023-04-10T03:26:06Z","timestamp":1681097166000},"page":"650","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Augmentative Plating versus Exchange Intramedullary Nailing for the Treatment of Aseptic Non-Unions of the Femoral Shaft\u2014A Biomechanical Study in a SawboneTM Model"],"prefix":"10.3390","volume":"13","author":[{"given":"Matthias Georg","family":"Walcher","sequence":"first","affiliation":[{"name":"OC W\u00fcrzburg, Oeggstr. 3, 97070 W\u00fcrzburg, Germany"},{"name":"Department of Orthopedics and Traumatology, Paracelsus Medical University, Breslauer Stra\u00dfe 201, 90471 Nuremberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3442-2298","authenticated-orcid":false,"given":"Robert E.","family":"Day","sequence":"additional","affiliation":[{"name":"Health Technology Management Unit, Royal Perth Hospital, University of Western Australia, 197 Wellington Street, Perth 6000, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3863-1580","authenticated-orcid":false,"given":"Markus","family":"Gesslein","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Paracelsus Medical University, Breslauer Stra\u00dfe 201, 90471 Nuremberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hermann Josef","family":"Bail","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Paracelsus Medical University, Breslauer Stra\u00dfe 201, 90471 Nuremberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Markus S.","family":"Kuster","sequence":"additional","affiliation":[{"name":"Perth Orthopaedic Sports Medicine Centre, The University of Western Australia, 31 Outram Street, Perth 6005, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,4,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"S76","DOI":"10.1016\/j.injury.2017.04.022","article-title":"Treatment of aseptic non-union after intramedullary nailing without removal of the nail","volume":"48","author":"Garnavos","year":"2017","journal-title":"Injury"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/j.ocl.2015.08.009","article-title":"Management of Aseptic Tibial and Femoral Diaphyseal Nonunions without Bony Defects","volume":"47","author":"Brinker","year":"2016","journal-title":"Orthop. 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