OBJECTIVE: Evaluate the effectiveness in terms of union rate and complications of a specific surgical technique for the management of recalcitrant nonunion of the distal femur (RNDF), using only cancellous autograft and extramedullary fixation devices at the Hospital Universitario Fundacion Santa de Bogotá (FSFB) between 2010 and 2021. MATERIALS AND METHODS: A retrospective analysis was carried out on cases of patients over 18 years of age diagnosed and treated for RNDF at the FSFB who had a minimum follow-up of 12 months or until union. Data collection, focused on fracture healing and identification of complications, was performed through medical record review, using relevant ICD-10 codes. Descriptive statistical techniques were used to analyze qualitative and quantitative variables. RESULTS: Of 1003 patients initially identified, 15 met the inclusion criteria. The average age was 48.7 years (range 27 to 74 years), with a female predominance of 53.3%. The average BMI was 24.8 kg/m². The average follow-up was 28.8 ± 17 months. The most of the fractures were located in the supracondylar region. Prior to the intervention studied, the average number of previous surgical procedures was 1.7 per patient. Consolidation was achieved in 93% of cases (14 of 15 patients) in an average time of 8 months. Complications included reinterventions in 6 patients and two cases of infection. CONCLUSIONS: The applied surgical technique, based on the use of cancellous autograft and extramedullary fixation, proved to be an effective and less invasive option to treat RNDF. These findings suggest that this technique may be a viable and simpler alternative compared to conventional methods, opening possibilities for future research that confirms and expands its applicability in the treatment of this complex condition.
