No article notes available at this time.
• Nonisthmal nonunions occur in the metaphyseal region where the canal is wider, so the mechanical stability gained from reaming and upsizing a nail — the rationale behind exchange nailing at the isthmus — may not translate well to this location; this study gives concrete failure data supporting that concern. • For trainees managing femoral nonunions after prior nailing, this study helps frame a location-specific decision: exchange nailing's high reported failure rate here suggests augmentation plating with bone grafting deserves strong consideration when the nonunion is nonisthmal. • The magnitude of difference (72% failure with EN vs 100% union with AP) is large enough to be clinically meaningful despite the small cohort, making this a useful reference when counseling on hardware strategy for femoral nonunion revision.
No article notes available at this time.
• Nonisthmal nonunions occur in the metaphyseal region where the canal is wider, so the mechanical stability gained from reaming and upsizing a nail — the rationale behind exchange nailing at the isthmus — may not translate well to this location; this study gives concrete failure data supporting that concern. • For trainees managing femoral nonunions after prior nailing, this study helps frame a location-specific decision: exchange nailing's high reported failure rate here suggests augmentation plating with bone grafting deserves strong consideration when the nonunion is nonisthmal. • The magnitude of difference (72% failure with EN vs 100% union with AP) is large enough to be clinically meaningful despite the small cohort, making this a useful reference when counseling on hardware strategy for femoral nonunion revision.