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Limb malalignment and functional outcome after antegrade versus retrograde intramedullary nailing in distal femoral fractures.
Salem, Khaled Hamed; Maier, Dirk; Keppler, Peter; Kinzl, Lothar; Gebhard, Florian.
Afiliación
  • Salem KH; Department of Trauma, Hand, and Reconstructive Surgery, University of Ulm, Ulm, Germany.
J Trauma ; 61(2): 375-81, 2006 Aug.
Article en En | MEDLINE | ID: mdl-16917453
BACKGROUND: Torsional malalignment and mechanical axis deviation (MAD) are worrisome complications after nailing of distal femoral fractures. Variable, sometimes contradictory, reports about these problems have been published. METHODS: In a retrospective nonrandomized study, 41 patients (mean age, 44.5 years) with distal third femoral fractures that were operatively treated using either antegrade (20 cases) or retrograde (21 cases) intramedullary nailing during a period of 2 years have been reviewed. Goniometric measurement was done using a navigated ultrasound examination whereas functional evaluation and return to sports were assessed using Merle d'Aubigné functional grading system and Tegner and Lysholm activity score. RESULTS: There was no difference in femoral length, torsion, or MAD between patients treated using antegrade nails and those treated with a retrograde nail. There was a greater limitation of knee motion with retrograde nailing and of hip motion with antegrade nailing. The functional grading and activity evaluation showed, however, no difference between both groups. CONCLUSIONS: The study cohort showed that no treatment method had proved an advantage over the other regarding limb geometry or the functional outcome. The proper operative indication, intraoperative control, and the surgeon's experience seem to be more important in this regard than the nailing technique.
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Clavos Ortopédicos / Fracturas Mal Unidas / Recuperación de la Función / Fracturas del Fémur / Fijación Intramedular de Fracturas Tipo de estudio: Etiology_studies / Observational_studies Límite: Adolescent / Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Trauma Año: 2006 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Estados Unidos
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Clavos Ortopédicos / Fracturas Mal Unidas / Recuperación de la Función / Fracturas del Fémur / Fijación Intramedular de Fracturas Tipo de estudio: Etiology_studies / Observational_studies Límite: Adolescent / Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Trauma Año: 2006 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Estados Unidos