Comparison Of Retrograde And Antegrade Intramedullary Nailing For Femoral Shaft Fractures

Objective:In the treatment of femoral shaft fracture,femoral intramedullary n iling in accordance with the surgical approach can be divided into antegrade i ntramedullary nailing and retrograde intramedullary nailing.We designed this clinical study to compare the effectiveness of retrograde and antegrade intrame dullary nailing in the treatment of femoral shaft fractures.To facilitate the sel ection of more reasonable clinical treatment,and explore the better application of intramedullary nailing in clinical.Methods: There were 76 cases of unilateral closed femoral shaft fractures wer e included in this prospective clinical study,who come from First Affiliated Hos pital Anhui Medical University in July 2014 to May 2016,All the fractures we re freshly diagnosed in the emergency group,and 40 patients were randomly incl uded in antegrade intramedullary nailing group and 36 patients were assigned to retrograde intramedullary nailing group.All patients were followed up for at lea st 6 months,and we observer and record the two surgical procedures(operation time,blood loss,the cases of limited incision),fracture healing(union time,heal ing type)and postoperative recovery(knee joint activity,hipand knee pain).Stati stical analysis was used to analyze the two groups of data.Results:The antegrade group operation time(125 ± 8)min and the retrograd e group operation time(114 ± 9)min.Significant difference(P<0.05)was foun d.There was no statistical difference between fracture healing time;(97±13)d for antegrade and(98 ± 13)d for retrograde(P>0.05).27 cases experienced knee pain,and there were 19 cases in the retrograde nailing group.8 cases of pa tients were treated with antegrade nailing.Significant difference(P<0.05)was fou nd in cases of knee pain.In the retrograde group,the early activity of the knee was significantly less than that of the anterograde group.But talking about the fra cture healing,we did not find any significant difference between the two groups.Conclusion: The two kinds of operation scheme in the treatment of femoral fractures can achieve good effects of fracture healing.But,there is more postoperative complications of kness pain after retrograde nailing.So we suggest that we should have a caution and comprehensive selection in its indications.