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Introduction: Close reduction and intra medullary nailing has been established as the treatment for femoral shaft fractures with a non::union:: rate of 0.9-1.1 % though, it is still controversial. Currently, the most accepted method for treatment of non ::union:: is exchange nailing. Therefore, this study aimed to investigate treatment of femoral shaft fractures non ::union:: via 2 methods of exchange nailing with bone graft and nail removal, and plating with bone graft. Methods: In this case series study, we included all patients with aseptic non::union:: femoral fracture who referred to Rasool-Akram hospital from 2007 to 2012 and were clinically indicated for reoperation for non::union:: after primary intra medullary nailing. Patients were assessed clinically and radiologically. The patients were treated via either method according to the type of non::union:: (atrophic, oligotrophic, hypertrophic). Collected data were recorded in check lists and analyzed with SPSS V.18 software. Results: Of 23 patients with mean age of 30.4±8.5 years, 13 (56%) were treated by exchange nailing with bone graft and 10 (44%) treated by plating and bone graft. Complete ::union:: was achieved in 85.7% of patients treated by exchange nailing and bone graft and in 90.9 % of patients treated with plating with bone graft. No leg length discrepancy, pain and infection were reported. Conclusion: This study suggests that treatment results of non::union:: femoral fractures with plating bone graft method is as good as or even better than exchange nailing with bone graft. In addition, the prevalence of femoral fracture non::union:: seems to be more than what was expected before.

Keywords: Exchange nailing; Femoral fracture; Intra medullary nailing; Non:union:; Plating

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