Knee pain and leg-length discrepancy after retrograde femoral nailing

We retrospectively studied postoperative knee function and leg-length discrepancy (LLD) in 31 patients with femoral diaphyseal fractures treated with retrograde intramedullary nailing (IMN) between October 1998 and April 2000. Mean follow-up was 25 months, mean knee range of motion was 126 degrees, mean Hospital for Special Surgery knee scores were 89.2 (pain) and 78.3 (function), and mean LLD was 1.19 cm. Despite the theoretically higher knee pain and LLD rates associated with retrograde IMN, we believe it may offer a viable treatment option when the antegrade nailing technique is restricted.