Skip to main content
Erschienen in: European Journal of Orthopaedic Surgery & Traumatology 6/2015

01.08.2015 | Original Article • KNEE - TRAUMA

Retrograde nailing of femoral fractures: a retrospective study

verfasst von: Sagar Shah, Pingal Desai, Varatharaj Mounasamy

Erschienen in: European Journal of Orthopaedic Surgery & Traumatology | Ausgabe 6/2015

Einloggen, um Zugang zu erhalten

Abstract

Background

Retrograde femoral nailing is a common method to repair femoral shaft fractures in polytrauma patients. Studies have reported varying incidences of complications associated with retrograde femoral nailing such as knee pain, nonunion, and arthrofibrosis. The objective of this retrospective study was to describe healing and complication rates of 31 patients who underwent retrograde femoral nailing at our academic medical center.

Methods

Clinical notes and radiographs were reviewed retrospectively. Data points such as demographics, fracture location on femur, time to union after surgery, presence or absence of comminution, associated injuries, and complications were assessed.

Results

Average time to union was 4.69 months with no statistically significant relationship found between time to union and age, sex, comminution, or location of fracture. Knee pain was present in 23 % of patients, and distal screw removal was necessary in 19.4 % of patients.

Discussion

Retrograde femoral nailing is an effective method of femoral shaft fracture fixation in polytrauma patients. The healing rate of femoral shaft fractures fixed with a retrograde nail is the same regardless of location of fracture, age, sex, or comminution. Prevention of tip of nail lying into the knee and early physical therapy are important to prevent arthrofibrosis knee.
Literatur
1.
Zurück zum Zitat Green S (1988) Distal intramedullary fixation of supracondylar fractures of femur. Tech Orthop 3:71–76CrossRef Green S (1988) Distal intramedullary fixation of supracondylar fractures of femur. Tech Orthop 3:71–76CrossRef
2.
Zurück zum Zitat Iannocone W, Bennett F, Delong W, Born C, Dalsey R (1994) Initial Experience with the treatment of supracondylar femoral fractures using the supracondylar intramedullary nail: a preliminary report. J Orthop Trauma 8:322–327CrossRef Iannocone W, Bennett F, Delong W, Born C, Dalsey R (1994) Initial Experience with the treatment of supracondylar femoral fractures using the supracondylar intramedullary nail: a preliminary report. J Orthop Trauma 8:322–327CrossRef
3.
Zurück zum Zitat Rokkanen P, Slatis P, Vankka E, Kelsinki F (1969) Closed or open intramedullary nailing of femoral shaft fractures. J Bone Joint Surg 51-BL:313–323 Rokkanen P, Slatis P, Vankka E, Kelsinki F (1969) Closed or open intramedullary nailing of femoral shaft fractures. J Bone Joint Surg 51-BL:313–323
4.
Zurück zum Zitat Winquist R, Hansen S, Clawson D (1984) Closed intramedullary nailing of femoral fractures. J Bone Joint Surg 66-A:529–539 Winquist R, Hansen S, Clawson D (1984) Closed intramedullary nailing of femoral fractures. J Bone Joint Surg 66-A:529–539
5.
Zurück zum Zitat Kempf I, Grosse A, Beck G (1985) Closed locked intramedullary nailing: its application to comminuted fractures of the femur. J Bone Joint Surg 67-A:709–720 Kempf I, Grosse A, Beck G (1985) Closed locked intramedullary nailing: its application to comminuted fractures of the femur. J Bone Joint Surg 67-A:709–720
6.
Zurück zum Zitat Gregory P, DiCicco J, Karpik K (1996) Ipsilateral fractures of the femur and tibia: treatment with retrograde femoral nailing and undreamed tibial nailing. J Orthop Trauma 10:309–316PubMedCrossRef Gregory P, DiCicco J, Karpik K (1996) Ipsilateral fractures of the femur and tibia: treatment with retrograde femoral nailing and undreamed tibial nailing. J Orthop Trauma 10:309–316PubMedCrossRef
7.
Zurück zum Zitat Ostrum RF (2000) Treatment of floating knee injuries through a single percutaneous approach. Clin Orthop Relat Res 375:43–50PubMedCrossRef Ostrum RF (2000) Treatment of floating knee injuries through a single percutaneous approach. Clin Orthop Relat Res 375:43–50PubMedCrossRef
8.
Zurück zum Zitat Ricci WM, Bellabarba C, Evanoff B (2001) Retrograde versus antegrade nailing of femoral shaft fractures. J Orthop Trauma 15:161–169PubMedCrossRef Ricci WM, Bellabarba C, Evanoff B (2001) Retrograde versus antegrade nailing of femoral shaft fractures. J Orthop Trauma 15:161–169PubMedCrossRef
9.
Zurück zum Zitat Tsai C, Hsu H, Fong Y, Lin C, Chen Y, Hsu C (2009) Treatment of ipsilateral fractures of femoral neck and shaft. Injury 40:778–782PubMedCrossRef Tsai C, Hsu H, Fong Y, Lin C, Chen Y, Hsu C (2009) Treatment of ipsilateral fractures of femoral neck and shaft. Injury 40:778–782PubMedCrossRef
10.
Zurück zum Zitat Watson J, Moed B (2002) Ipsilateral femoral neck and shaft fractures: complications and their treatment. Clin Orthop Relat Res 399:78–86PubMedCrossRef Watson J, Moed B (2002) Ipsilateral femoral neck and shaft fractures: complications and their treatment. Clin Orthop Relat Res 399:78–86PubMedCrossRef
11.
Zurück zum Zitat Alho A (1996) Concurrent ipsilateral fractures of the hip and shaft of the femur. A systematic review of 722 cases. Ann Chir Gynaecol 86:326–336 Alho A (1996) Concurrent ipsilateral fractures of the hip and shaft of the femur. A systematic review of 722 cases. Ann Chir Gynaecol 86:326–336
12.
Zurück zum Zitat Oh C, Oh J, Park B, Jeon I, Kyung H, Kim S, Park I, Sohn O, Min W (2006) Retrograde nailing with subsequent screw fixation for ipsilateral femoral shaft and neck fractures. Arch Orthop Trauma Surg 126:448–453PubMedCrossRef Oh C, Oh J, Park B, Jeon I, Kyung H, Kim S, Park I, Sohn O, Min W (2006) Retrograde nailing with subsequent screw fixation for ipsilateral femoral shaft and neck fractures. Arch Orthop Trauma Surg 126:448–453PubMedCrossRef
13.
Zurück zum Zitat Moed B, Watson J (1995) Retrograde intramedullary nailing without reaming of fractures of the femoral shaft in multiply injured patients. J Bone Joint Surg 77:1520–1527PubMed Moed B, Watson J (1995) Retrograde intramedullary nailing without reaming of fractures of the femoral shaft in multiply injured patients. J Bone Joint Surg 77:1520–1527PubMed
14.
Zurück zum Zitat Moed B, Watson J (1999) Retrograde nailing of the femoral shaft. J Am Acad Orthop Surg 7:209–216PubMed Moed B, Watson J (1999) Retrograde nailing of the femoral shaft. J Am Acad Orthop Surg 7:209–216PubMed
15.
Zurück zum Zitat Krettek C, Miclau T, Grun O, Schandelmaier P, Tscherne H (1998) Intraoperative control of axes, rotation and length of femoral and tibial fractures. Injury 29:S-C29–S-C39CrossRef Krettek C, Miclau T, Grun O, Schandelmaier P, Tscherne H (1998) Intraoperative control of axes, rotation and length of femoral and tibial fractures. Injury 29:S-C29–S-C39CrossRef
16.
Zurück zum Zitat Jaarsma R, Pakvis D, Verdonschot Biert J, van Kampen A (2004) Rotational malalignment after intramedullary nailing of femoral fractures. J Orthop Trauma 18:403–409PubMedCrossRef Jaarsma R, Pakvis D, Verdonschot Biert J, van Kampen A (2004) Rotational malalignment after intramedullary nailing of femoral fractures. J Orthop Trauma 18:403–409PubMedCrossRef
17.
Zurück zum Zitat Deshmukh R, Lou K, Neo C, Yew K, Rozman I, George J (1998) A technique to obtain correct rotational alignment during closed locked intramedullary nailing of the femur. Injury 29:207–210PubMedCrossRef Deshmukh R, Lou K, Neo C, Yew K, Rozman I, George J (1998) A technique to obtain correct rotational alignment during closed locked intramedullary nailing of the femur. Injury 29:207–210PubMedCrossRef
18.
Zurück zum Zitat Braten M, Tveit K, Junk S, Aamodt A, Anda S, Terjesen T (2000) The role of fluoroscopy in avoiding rotational deformity of treated femoral shaft fractures: an anatomical and clinical study. Injury 31:311–315PubMedCrossRef Braten M, Tveit K, Junk S, Aamodt A, Anda S, Terjesen T (2000) The role of fluoroscopy in avoiding rotational deformity of treated femoral shaft fractures: an anatomical and clinical study. Injury 31:311–315PubMedCrossRef
19.
Zurück zum Zitat Acharya K, Rao M (2006) Retrograde nailing for distal third femoral shaft fractures: a prospective study. J Orthop Surg 14:253–258 Acharya K, Rao M (2006) Retrograde nailing for distal third femoral shaft fractures: a prospective study. J Orthop Surg 14:253–258
20.
Zurück zum Zitat Morshed S (2014) Current options for determining fracture union. Adv Med 2014:1–12CrossRef Morshed S (2014) Current options for determining fracture union. Adv Med 2014:1–12CrossRef
21.
Zurück zum Zitat Gilatis J, Kouzelis A, Matzaroglou C, Lambris E (2006) Arthroscopically assisted retrograde intramedullary fixation for fractures of the distal femur: technique, indication and results. Knee Surg Sports Traumatol Arthrosc 14:114–119CrossRef Gilatis J, Kouzelis A, Matzaroglou C, Lambris E (2006) Arthroscopically assisted retrograde intramedullary fixation for fractures of the distal femur: technique, indication and results. Knee Surg Sports Traumatol Arthrosc 14:114–119CrossRef
22.
Zurück zum Zitat El-Kawy S, Ansara S, Moftah A, Shalaby H, Varughese V (2006) Retrograde femoral nailing in elderly patients with supracondylar fracture femur; is it the answer for a clinical problem? Int Orthop 31:83–86PubMedCentralPubMedCrossRef El-Kawy S, Ansara S, Moftah A, Shalaby H, Varughese V (2006) Retrograde femoral nailing in elderly patients with supracondylar fracture femur; is it the answer for a clinical problem? Int Orthop 31:83–86PubMedCentralPubMedCrossRef
23.
Zurück zum Zitat Papadokostakis G, Papakostidis C, Dimitriou R, Giannoudis P (2004) The role and efficacy of retrograding nailing for the treatment of diaphyseal and distal femoral fractures: a systematic review of the literature. Injury 36:813–822CrossRef Papadokostakis G, Papakostidis C, Dimitriou R, Giannoudis P (2004) The role and efficacy of retrograding nailing for the treatment of diaphyseal and distal femoral fractures: a systematic review of the literature. Injury 36:813–822CrossRef
24.
Zurück zum Zitat Becher S, Ziran B (2012) Retrograde intramedullary nailing of open femoral shaft fractures: a retrospective case series. J Trauma Acute Care Surg 72:696–698PubMedCrossRef Becher S, Ziran B (2012) Retrograde intramedullary nailing of open femoral shaft fractures: a retrospective case series. J Trauma Acute Care Surg 72:696–698PubMedCrossRef
25.
Zurück zum Zitat Ostrum R, Maurer J (2009) Distal third femur fractures treated with retrograde femoral nailing and blocking screws. J Orthop Trauma 23:681–684PubMedCrossRef Ostrum R, Maurer J (2009) Distal third femur fractures treated with retrograde femoral nailing and blocking screws. J Orthop Trauma 23:681–684PubMedCrossRef
26.
Zurück zum Zitat Cannada L, Taghizadeh S, Murali J, Obremskey W, DeCook C, Bosse M (2008) Retrograde intramedullary nailing in treatment of bilateral femur fractures. J Orthop Trauma 22:530–534PubMedCrossRef Cannada L, Taghizadeh S, Murali J, Obremskey W, DeCook C, Bosse M (2008) Retrograde intramedullary nailing in treatment of bilateral femur fractures. J Orthop Trauma 22:530–534PubMedCrossRef
27.
Zurück zum Zitat Lucas E, Seligson D, Henry S (1993) Intramedullary supracondylar nailing of femoral fractures: a preliminary report of the GSH supracondylar nail. Clin Orthop Relat Res 296:200–206PubMed Lucas E, Seligson D, Henry S (1993) Intramedullary supracondylar nailing of femoral fractures: a preliminary report of the GSH supracondylar nail. Clin Orthop Relat Res 296:200–206PubMed
28.
Zurück zum Zitat Ostrum R, DiCicco J, Lakatos R, Poka A (1998) Retrograde intramedullary nailing of femoral diaphysis fractures. J Orthop Trauma 12:464–468PubMedCrossRef Ostrum R, DiCicco J, Lakatos R, Poka A (1998) Retrograde intramedullary nailing of femoral diaphysis fractures. J Orthop Trauma 12:464–468PubMedCrossRef
29.
Zurück zum Zitat Braten M, Terjesen T, Rossvoll I (1995) Femoral shaft fractures treated by intramedullary nailing. A follow-up study focusing on problems related to the method. Injury 26:379–383PubMedCrossRef Braten M, Terjesen T, Rossvoll I (1995) Femoral shaft fractures treated by intramedullary nailing. A follow-up study focusing on problems related to the method. Injury 26:379–383PubMedCrossRef
Metadaten
Titel
Retrograde nailing of femoral fractures: a retrospective study
verfasst von
Sagar Shah
Pingal Desai
Varatharaj Mounasamy
Publikationsdatum
01.08.2015
Verlag
Springer Paris
Erschienen in
European Journal of Orthopaedic Surgery & Traumatology / Ausgabe 6/2015
Print ISSN: 1633-8065
Elektronische ISSN: 1432-1068
DOI
https://doi.org/10.1007/s00590-015-1658-6

Weitere Artikel der Ausgabe 6/2015

European Journal of Orthopaedic Surgery & Traumatology 6/2015 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

TEP mit Roboterhilfe führt nicht zu größerer Zufriedenheit

15.05.2024 Knie-TEP Nachrichten

Der Einsatz von Operationsrobotern für den Einbau von Totalendoprothesen des Kniegelenks hat die Präzision der Eingriffe erhöht. Für die postoperative Zufriedenheit der Patienten scheint das aber unerheblich zu sein, wie eine Studie zeigt.

Lever-Sign-Test hilft beim Verdacht auf Kreuzbandriss

15.05.2024 Vordere Kreuzbandruptur Nachrichten

Mit dem Hebelzeichen-Test lässt sich offenbar recht zuverlässig feststellen, ob ein vorderes Kreuzband gerissen ist. In einer Metaanalyse war die Vorhersagekraft vor allem bei positivem Testergebnis hoch.

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

07.05.2024 Klinik aktuell Nachrichten

Extreme Arbeitsverdichtung und kaum Supervision: Dr. Andrea Martini, Sprecherin des Bündnisses Junge Ärztinnen und Ärzte (BJÄ) über den Frust des ärztlichen Nachwuchses und die Vorteile des Rucksack-Modells.

Aquatherapie bei Fibromyalgie wirksamer als Trockenübungen

03.05.2024 Fibromyalgiesyndrom Nachrichten

Bewegungs-, Dehnungs- und Entspannungsübungen im Wasser lindern die Beschwerden von Patientinnen mit Fibromyalgie besser als das Üben auf trockenem Land. Das geht aus einer spanisch-brasilianischen Vergleichsstudie hervor.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.