Assessment of clinical and radiographic outcomes following retrograde versus antegrade nailing of infraisthmic femoral shaft fractures without the use of intraoperative fluoroscopy in Tanzania.
| Autor: | von Kaeppler EP; Institute for Global Orthopaedics and Traumatology, Department of Orthopaedic Surgery, University of California San Francisco School of Medicine, San Francisco, CA., Donnelley CA; Institute for Global Orthopaedics and Traumatology, Department of Orthopaedic Surgery, University of California San Francisco School of Medicine, San Francisco, CA., Roberts HJ; Institute for Global Orthopaedics and Traumatology, Department of Orthopaedic Surgery, University of California San Francisco School of Medicine, San Francisco, CA., Eliezer EN; Muhimbili Orthopaedic Institute, Muhimbili National Hospital, Dar es Salaam, Tanzania., Haonga BT; Muhimbili Orthopaedic Institute, Muhimbili National Hospital, Dar es Salaam, Tanzania., Morshed S; Institute for Global Orthopaedics and Traumatology, Department of Orthopaedic Surgery, University of California San Francisco School of Medicine, San Francisco, CA., Shearer DW; Institute for Global Orthopaedics and Traumatology, Department of Orthopaedic Surgery, University of California San Francisco School of Medicine, San Francisco, CA. |
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| Jazyk: | angličtina |
| Zdroj: | OTA international : the open access journal of orthopaedic trauma [OTA Int] 2021 Mar 22; Vol. 4 (2), pp. e125. Date of Electronic Publication: 2021 Mar 22 (Print Publication: 2021). |
| DOI: | 10.1097/OI9.0000000000000125 |
| Abstrakt: | To compare clinical and radiographic outcomes following antegrade versus retrograde intramedullary nailing of infraisthmic femoral shaft fractures. Design: Secondary analysis of prospective cohort study. Setting: Tertiary hospital in Tanzania. Participants: Adult patients with infraisthmic diaphyseal femur fractures. Intervention: Antegrade or retrograde SIGN intramedullary nail. Outcomes: Health-related quality of life (HRQOL), radiographic healing, knee range of motion, pain, and alignment (defined as less than or equal to 5 degrees of angular deformity in both coronal and sagittal planes) assessed at 6, 12, 24, and 52 weeks postoperatively. Results: Of 160 included patients, 141 (88.1%) had 1-year follow-up and were included in analyses: 42 (29.8%) antegrade, 99 (70.2%) retrograde. Antegrade-nailed patients had more loss of coronal alignment ( P = .026), but less knee pain at 6 months ( P = .017) and increased knee flexion at 6 weeks ( P = .021). There were no significant differences in reoperations, HRQOL, hip pain, knee extension, radiographic healing, or sagittal alignment. Conclusions: Antegrade nailing of infraisthmic femur fractures had higher incidence of alignment loss, but no detectable differences in HRQOL, pain, radiographic healing, or reoperation. Retrograde nailing was associated with increased knee pain and decreased knee range of motion at early time points, but this dissipated by 1 year. To our knowledge, this is the first study to prospectively compare outcomes over 1 year in patients treated with antegrade versus retrograde SIGN intramedullary nailing of infraisthmic femur fractures.Level of Evidence: III. Competing Interests: The authors have no conflicts of interest to disclose. (Copyright © 2021 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Orthopaedic Trauma Association.) |
| Databáze: | MEDLINE |
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