Related Experiment Video
Updated: Sep 28, 2026
Treatment with Locking Intramedullary Nailing for Intertrochanteric Fracture of the Femur Utilizing a New Awl with a Distal Positioner
Published on: June 6, 2025
[Retrograde intramedullary nailing of femoral shaft fractures. A prospective study]
F Holmenschlager1, S Piatek, J P Halm
1Klinik für Unfallchirurgie, Otto-von-Guericke-Universität, Magdeburg. francis.holmenschlager@medizin.uni-magdeburg.de
Purpose Of The Study:
Antegrade intramedullary nailing is seen as a most effective method in the management of femoral fractures. However, complications may arise due to the surgical approach.Can these disadvantages be avoided by using a retrograde approach?
Material And Methods:
In a prospective study 70 femoral fractures in 62 patients were stabilised using a long intramedullary nail by a retrograde approach.
Results:
We were able to re-examine 50 patients (57 fractures) 13,3 (3-36) months after the operation. Apart from one non-union by infection, all fractures healed in time. Flexion of the knee joint was within a normal ROM in 81% of shaft fractures 12 months or more after the operation, as was the case in 44% of distal fractures. A inhibition of extension was not found in any patient. Two patients had a femoral shortening of up to one centimeter. We observed no rotational malalignment of more than 5 degrees. The clinical results were excellent in 89% of shaft fractures, and in 50% of supra-/diacondylar fractures. In 18 cases a nail removal was already performed, thereby allowing an arthroscopic follow-up inspection of the knee joint. No knee pathology due to nailing was found in either case.
Conclusion:
Our results show the advantages of retrograde intramedullary nailing in comparison to the antegrade method.
