[Abstract] Objective To investigate the clinical effect of bridge combined fixation system together with decortication in treatment for femoral shaft nonunion after plate fixation. Methods A total of 29 patients with femoral shaft nonunion after plate fixation were enrolled. The original fixation devices were removed and bridge combined fixation system combined with decorticated autogenous bone graft were applied to treat the patients. The intraoperative bleeding, operating time, length of hospital stay and incision healing were observed. Harris and HSS score were used to evaluate the function of the hip and knee joint respectively before and after surgery. Results All the patients were followed up for 12～18 (± s, 17.24±3.79) months. The patients’ intraoperative bleeding was 200～550 (± s, 387.93±75.94) ml,the operating time was 70～110 (± s, 91.52±9.74) min, and the length of hospital stay was 5～12 (± s, 8.66±1.99) days. The incision healing of all but one patients were primary healing. As compared to the preoperative function, the Harris hip scores and the HSS knee scores were significantly improved at the last follow-up (Harris, 76.72±4.87 vs 88.52±5.15; HSS,73.45±6.56 vs 86.07±8.00; P<0.05). The fractures of all patients were healed with the healing time of 4.50～8.50 (± s,, 5.93±1.22) months. Conclusion The bridge combined fixation system together with decortication in treating femoral shaft nonunion after plate fixation is an effective procedure and satisfactory clinical outcome can be obtained.