A Comparative Study of Postoperative Efficacy Between Antegrade and Retrograde Intramedullary Nailing in the Treatment of Middle Femoral Shaft Fractures
Department of Orthopaedics，909th Hospital，School of Medicine，Xiamen University
Objective To compare the rotational malalignment and joint function outcomes of antegrade and retrograde intramedullary nailing in femoral shaft fractures.Methods A retrospective review was conducted on 45 patients with femoral shaft fractures treated with intramedullary in the Department of Orthopaedics of Southeast Hospital Affiliated to Xiamen Universit between March 2019 and March 2021.28 males and 17 females were included.The patients aged 18 to 60 years，with a mean age of (39.5±10.4)years.There were 21 cases of the left side and 24 cases of the right side.Based on the fixation method，26 cases were included in the antegrade group (17 males，9 females).The patients aged 22 to 60 years，with a mean age of (39.8±11.0) years.19 cases were inlcuded in the retrograde group (11 males，8 females).The patients aged 21 to 60 years，with a mean age of (39.2±9.9) years.The postoperative femoral rotation angle，Harris hip joint function score，and Lysholm knee joint function score were compared between groups.Results All 45 patients were followed 9 to 15 months，with an average of (10.1±3.3) months.The immediate postoperative femoral rotation angle was (11.4±4.0)° in the antegrade group and (7.7±4.3)° in the retrograde group.The retrograde group exhibited a smaller rotation angle，a difference that was statistically significant (P＜0.05).9 months postoperatively，the angles were (11.2±4.3)° and (7.7±4.0)° for the antegrade and retrograde groups respectively，again showing a significant difference (P＜0.05).No significant difference in rotation angle was observed at 9 months postoperatively compared to immediately post-surgery (P＞0.05).At the final follow-up，the antegrade group had a Harris score of (90.9±2.7) and a Lysholm score of (92.1±3.1)，while the retrograde group scored (93.1±2.5) and (90.6±2.4) respectively.The differences were not statistically significant (P＞0.05).However，the incidence of knee pain in the retrograde group (26.3%) was significantly higher than in the antegrade group (3.8%) (P＜0.05).Knee flexion was (130.5±5.4)° in the antegrade group and (127.1±4.5)° in the retrograde group，a statistically significant difference (P＜0.05).Conclusion Both antegrade and retrograde intramedullary nailing offer satisfactory clinical outcomes for midshaft femoral fractures.Although the retrograde approach has a smaller postoperative rotational angle，it is associated with reduced knee flexion and a higher incidence of knee pain compared to the antegrade approach
宋伟，徐维臻，刘晖，罗德庆，张金辉，吴进. 顺行和逆行髓内钉治疗股骨干中段骨折术后疗效对比[J]. 实用骨科杂志, 2024, 30(1): 24-.
Song Wei，Xu Weizhen，Liu Hui，Luo Deqing，Zhang Jinhui，Wu Jin. A Comparative Study of Postoperative Efficacy Between Antegrade and Retrograde Intramedullary Nailing in the Treatment of Middle Femoral Shaft Fractures. sygkzz, 2024, 30(1): 24-.
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