Antegrade vs Retrograde Intra-Medullary Nailing in Femoral Shaft Fractures: A Systematic Review and Meta-Analysis.

Articles in Press

Document Type : SYSTEMATIC REVIEW

Authors

1 Brown University

2 Hotel Dieu de France

3 LAUMCRH

4 Mcgill

10.22038/abjs.2024.78871.3623

Abstract

Objectives: Femoral shaft fractures are one of the most prevalent fractures found in clinical practice. Numerous operative and non-operative options are readily available for the treatment of such fractures with intra-medullary nailing being the gold standard. To date, no consensus has been reached favoring one approach over the other. Thus, this meta-analysis aims to compare the outcomes between an antegrade and retrograde intra-medullary nailing for the treatment of femoral shaft fractures.

Methods: PubMed, Cochrane, Google Scholar (page 1-20), and Embase were searched till January 2024. The clinical outcomes evaluated were the incidence of adverse events, reoperations, hip and knee pain, and surgery-related parameters.

Results: Higher rates of hip pain, and heterotopic ossification (p=0.0003, and p=0.0002 respectively) was observed with antegrade nailing. However, a higher rate of knee pain (p=0.02) was appreciated in retrograde nailing. There was no statistically significant difference in the remaining analyzed outcomes such as operative time, reoperation rate or other complications.

Conclusion: Despite a higher rate of heterotopic ossification using the antegrade nailing technique, both the antegrade and retrograde nailing techniques yield overall similar outcomes. Therefore, the decision to choose one or the other should be based on patient-related factors, and the surgeon’s experience and preference.

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The Archives of Bone and Joint Surgery

Articles in Press, Accepted Manuscript
Available Online from 02 June 2024

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History

  • Receive Date: 03 April 2024
  • Revise Date: 26 May 2024
  • Accept Date: 23 May 2024

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