Treatment of choice for old non-united fracture of shaft of femur –
**Core Concept**
Non-united fractures of the femoral shaft, particularly in older patients, require a treatment approach that balances stability, bone healing, and patient mobility. The goal is to promote fracture union while minimizing the risk of complications.
**Why the Correct Answer is Right**
The treatment of choice for an old non-united fracture of the shaft of the femur is usually **nailing**, specifically intramedullary nailing (IMN). This method provides stability to the fracture site, allowing for bone healing to occur. IMN involves inserting a rod into the medullary canal of the femur, which helps to compress the fracture fragments and promote union. This technique is particularly effective in older patients, as it allows for early weight-bearing and mobilization, reducing the risk of further complications such as pressure sores and deep vein thrombosis.
**Why Each Wrong Option is Incorrect**
* **Option A:** This option is incorrect as it does not specify a treatment method that provides the necessary stability for fracture union in an older patient.
* **Option B:** This option is incorrect as it is not a suitable treatment for non-united fractures of the femoral shaft, as it may not provide sufficient stability for bone healing.
* **Option D:** This option is incorrect as it is not a common treatment for non-united fractures of the femoral shaft, and may not be effective in promoting fracture union in older patients.
**Clinical Pearl / High-Yield Fact**
Intramedullary nailing is a widely accepted treatment for non-united fractures of the femoral shaft, particularly in older patients, due to its ability to promote fracture union while allowing for early weight-bearing and mobilization.
**Correct Answer: C. Intramedullary nailing.**