الفهرس 
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Abstract
Background: Management of diaphyseal femoral fracture non-union on top of intra-medullary nailing is still debatable.
Aim: The aim of this work was to compare the clinical and radiographic outcomes of exchange nailing versus plate augmentation for the management of patients with non-union of diaphyseal femoral fractures.
Patients and Methods: This prospective study was conducted at Department of Orthopedics and Traumatology, Menoufia University Hospital, between May 2017 and July 2019; including (24) patients of non-union of diaphyseal femoral fractures fixed by intramedullary interlocking nail. Patients were mutually categorized according to the planned management into two groups; Group-(A) of (12) patients who were managed by exchange nailing and bone grafting; and Group-(B) of (12) patients to who were managed by augmentation plating and bone grafting.
Results: Statistically, patients were matched as regards demographics, pre-operative findings of clinical examination and radiographic evaluation. Group-(A) had significantly longer operative duration and higher reoperation rate compared with Group-(B), P-values= 0.001 and 0.021 respectively. There was no significant difference between studied groups as regards duration till fracture healing, P-value=0.281.
Conclusion: Diaphyseal femoral fracture non-union can be successfully treated by either exchange nailing and bone grafting or by augmentation plating and bone grafting; however, the later has less operative time and lower re-operation rate.