Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 8 2 2022 05 18 48 51 EN Babak Siavashi Orthopedic Surgery Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran Mohammad Rastegar Orthopedic Surgery Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran Yousof Fallah Orthopedic Surgery Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran Ehsan Pendar Orthopedic Surgery Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran Mohammad Soleimani Orthopedic Surgery Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran Seyyed Hossein Shafiei Orthopedic Surgery Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran 2021 10 20 2022 02 26 Background: Several treatment approaches are now considered to manage tibial and femoral shaft nonunion after primary surgeries. Double-locking plates with channel bone grafting technology are treatments that surgeons could choose. We aimed to describe our experiences in evaluating the union of bone for these patients after using double-locking plates with channel bone grafting with serial examinations and radiologic studies. Methods: This case study was conducted on 33 patients consisting of 20 femoral nonunion and 13 tibial nonunion cases. They underwent double plate fixation with bone grafting at Sina Hospital, Tehran, Iran, from 2015 to 2020. They were monitored for an average of 60 months after surgery. Results: Union was achieved in all the patients in a mean of 10.03 months (range: 8-18 months). During patients’ follow-up, no plate and screw breakage, device loosening, deformity, and infection were seen. No additional surgery was needed for any of our patients. Conclusion: There are various treatment options for nonunion of long bones. This study described the double plating approach for treating femoral and tibial shaft nonunion. The technique of double plate fixation and bone grafting had reasonable union rates in long bone nonunion. The present case series analysis also shows that it is more beneficial to manipulate this promising method for long bone nonunion whenever possible. https://jost.tums.ac.ir/index.php/jost/article/view/326 https://jost.tums.ac.ir/index.php/jost/article/download/326/264