Delayed Unions or Nonunions of the Distal Femur

➢ The failure rate of treatment of nonunions of the distal femur with internal fixation and autologous bone grafting remains high at 20% to 30%. ➢ Successful treatment of nonunions of the distal femur requires good mechanical stability combined with autologous bone graft. This may require dual-plate fixation or intramedullary nail-plate combinations. ➢ Autologous bone graft remains the bone graft of choice. Bone-graft substitutes and biologics require further research.