| Citation: |
MAO Wenwen, CHEN Hao, LI Li, CHEN Gang, ZHANG Min, LI Ke, ZHU Yousen. Retrograde and anterograde intramedullary nailing in treating midshaft fracture of femoral shaft[J]. Journal of Clinical Medicine in Practice, 2022, 26(17): 87-91. DOI: 10.7619/jcmp.20221266
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To observe the efficacy and complications of retrograde femoral intramedullary nailing and anterograde femoral intramedullary nailing in the treatment of midshaft fracture of femoral shaft.
A total of 76 patients with middle femoral shaft fracture were included in this study. According to the different placement methods of main screws, they were divided into retrograde group (36 cases) and anterograde group (40 cases). The conditions of perioperation, during follow-up and occurrence of complications of the two groups were compared.
There were no significant differences in diameter of intramedullary nail, the number of fluoroscopy, the number of screws at both ends of fracture between the two groups (P > 0.05). In the retrograde group, the operation time was shorter than that in the anterograde group, and amount of bleeding was more than that in the anterograde group (P < 0.05). At the last follow-up, there were no significant differences in fracture healing time, Harris score, Lysholm score and fracture healing rate between the two groups (P > 0.05). The knee flexion degree in the anterograde group was (130.22±4.31)°, which was better than (126.58±8.41)° in the retrograde group, and the incidence of knee pain in the retrograde group was 19.4%, which was significantly higher than 2.5% in the anterograde group (P < 0.05).
Both retrograde intramedullary nail and anterograde intramedullary nail can achieve satisfactory clinical effects in the treatment of middle femoral shaft fractures. Retrograde nail placement is relatively convenient without traction bed, but there are relatively more complications in knee joint after retrograde nail fixation.
| [1] |
MEMARZADEH A, TISSINGH E K, HULL P, et al. Intramedullary nailing of femoral shaft fractures in adults[J]. Orthop Trauma, 2017, 31(2): 86-92. doi: 10.1016/j.mporth.2016.11.001
|
| [2] |
王秋根. 髓内钉固定治疗成人股骨干骨折的相关问题[J]. 中华创伤杂志, 2017, 33(1): 6-9. doi: 10.3760/cma.j.issn.1001-8050.2017.01.003
|
| [3] |
RICCI W M, BELLABARBA C, EVANOFF B, et al. Retrograde versus antegrade nailing of femoral shaft fractures[J]. J Orthop Trauma, 2001, 15(3): 161-169. doi: 10.1097/00005131-200103000-00003
|
| [4] |
HUSSAIN N, HUSSAIN F N, SERMER C, et al. Antegrade versus retrograde nailing techniques and trochanteric versus piriformis intramedullary nailing entry points for femoral shaft fractures: a systematic review and meta-analysis[J]. Can J Surg, 2017, 60(1): 19-29.
|
| [5] |
RICCI W M, GALLAGHER B, HAIDUKEWYCH G J. Intramedullary nailing of femoral shaft fractures: current concepts[J]. J Am Acad Orthop Surg, 2009, 17(5): 296-305. doi: 10.5435/00124635-200905000-00004
|
| [6] |
TESTA G, VESCIO A, ALOJ D C, et al. Definitive treatment of femoral shaft fractures: comparison between anterograde intramedullary nailing and monoaxial external fixation[J]. J Clin Med, 2019, 8(8): 1119. doi: 10.3390/jcm8081119
|
| [7] |
陶勇, 江渟, 田克超. 芯钻远端锁定系统在髓内钉治疗股骨干骨折中的作用[J]. 中国组织工程研究, 2019, 23(36): 5800-5805. doi: 10.3969/j.issn.2095-4344.1436
|
| [8] |
SWIONTKOWSKI M F, HANSEN S T Jr, KELLAM J. Ipsilateral fractures of the femoral neck and shaft. A treatment protocol[J]. J Bone Joint Surg Am, 1984, 66(2): 260-268. doi: 10.2106/00004623-198466020-00013
|
| [9] |
SANDERS R, KOVAL K J, DIPASQUALE T, et al. Retrograde reamed femoral nailing[J]. J Orthop Trauma, 2014, 28(Suppl 8): S15-S24.
|
| [10] |
桂鹏, 邹毅, 冷华伟, 等. 闭合与开放髓内钉治疗股骨干骨折比较[J]. 中国矫形外科杂志, 2020, 28(22): 2027-2031. https://www.cnki.com.cn/Article/CJFDTOTAL-ZJXS202022005.htm
|
| [11] |
SALEM K H, MAIER D, KEPPLER P, et al. Limb malalignment and functional outcome after antegrade versus retrograde intramedullary nailing in distal femoral fractures[J]. J Trauma, 2006, 61(2): 375-381. doi: 10.1097/01.ta.0000230282.65606.81
|
| [12] |
METSEMAKERS W J, ROELS N, BELMANS A, et al. Risk factors for nonunion after intramedullary nailing of femoral shaft fractures: remaining controversies[J]. Injury, 2015, 46(8): 1601-1607. doi: 10.1016/j.injury.2015.05.007
|
| [13] |
PETTETT B J, AVERY M C, OSTRUM R F. Retrograde femoral nailing using percutaneous reduction techniques[J]. J Orthop Trauma, 2017, 31(Suppl 3): S6-S7.
|
| [14] |
桂景雄, 邓志成, 朱小华, 等. 有限切开复位在髓内钉治疗股骨干骨折中的应用评价[J]. 中国医师进修杂志, 2020, 43(3): 265-270. doi: 10.3760/cma.j.issn.1673-4904.2020.03.017
|
| [15] |
YOON R S, ADAMS D M, SEIGERMAN D A, et al. Impact of surrounding canal size on time to union after intramedullary nailing of femur fractures: are 10-mm nails all we need[J]. J Orthop Trauma, 2020, 34(4): 180-185. doi: 10.1097/BOT.0000000000001670
|
| [16] |
ZHANG F, ZHU L, LI Y C, et al. Retrograde versus antegrade intramedullary nailing for femoral fractures: a meta-analysis of randomized controlled trials[J]. Curr Med Res Opin, 2015, 31(10): 1897-1902. doi: 10.1185/03007995.2015.1078783
|
| [17] |
EL MOUMNI M, VOOGD E H, TEN DUIS H J, et al. Long-term functional outcome following intramedullary nailing of femoral shaft fractures[J]. Injury, 2012, 43(7): 1154-1158. doi: 10.1016/j.injury.2012.03.011
|
| [18] |
KIM J W, OH C W, OH J K, et al. Treatment of infra-isthmal femoral fracture with an intramedullary nail: is retrograde nailing a better option than antegrade nailing[J]. Arch Orthop Trauma Surg, 2018, 138(9): 1241-1247.
|
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