We report the case of a 41-year-old man who sustained an open femoral shaft fracture with 10 cm of segmental bone loss in a motorcycle collision. He underwent serial irrigation and debridement procedures and intramedullary nailing of the fracture. He was lost to follow-up, but presented 9 months after the injury with abundant callus formation; at 11 months, the simple hypertrophic nonunion was treated with exchange nailing.
Although unusual, secondary union of segmental femoral defects may occur. The mechanism by which this occurs is poorly understood, but is likely related to the biology of the fracture site, the effects of reaming, and the mechanics of the fixation.
1Department of Orthopedic Surgery, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, Texas
E-mail address for T.S. Achor: firstname.lastname@example.org