Purpose: Fracture nonunions are commonly encountered by orthopaedic surgeons. Many techniques are currently available for the management of long-bone nonunions. This video demonstrates the use of iliac crest bone graft and plate stabilization in the management of a hypertrophic femoral nonunion.

Methods: Management of a femoral nonunion after intramedullary nail fixation with the use of compression plating and bone grafting is a reliable technique to decrease pain, improve function, and achieve radiographic union. In addition, the use of autologous bone graft, particularly iliac crest bone graft, provides reliable clinical results.

Results: This video discusses the case presentation of a patient with a hypertrophic femoral nonunion who was treated via supplemental bone grafting and plate and screw fixation.

Conclusions: Although femoral nonunions are relatively rare, they can be reasonably managed via stabilization and supplemental bone grafting. Iliac crest bone graft provides excellent results in the management of fracture nonunions.