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Updated: Aug 3, 2026
An Intramedullary Locking Nail for Standardized Fixation of Femur Osteotomies to Analyze Normal and Defective Bone Healing in Mice
Published on: November 13, 2016
Retrograde intramedullary nailing is an appropriate approach to pathologic femur fracture fixation: a retrospective
Margaret A Sinkler1, Jeremy M Adelstein2, Luc M Fortier1
1Department of Orthopaedic Surgery, University Hospitals, Case Western Reserve University, Cleveland, USA.
Purpose:
To present the clinical outcomes of pathologic femur fractures treated with retrograde intramedullary nails (rIMNs) and to compare outcomes to a matched antegrade IMN (aIMN) cohort.
Methods:
We retrospectively reviewed pathologic femur fractures that underwent IMNs from 2014-2021. Clinical outcomes of patients undergoing rIMN were collected. The patients who received a rIMN were then propensity matched to aIMNs based on age, BMI, smoking status, pre-operative concomitant therapy, and post-operative concomitant therapy. Univariate analysis was conducted with Chi-square or Mann-Whitney U tests.
Results:
19 patients who received rIMN for pathologic lesions were identified. 17 patients had complete fractures mostly in the distal diaphysis (15). No patients had local recurrence and six had progression of their disease. The 19 rIMN patients were matched to 19 patients who received an aIMN. The primary lesions included breast (n = 9, 24%), lung (n = 6, 16%), and kidney (n = 4, 11%). The rIMN cohort had more complete fractures compared to the aIMN cohort (17 vs. 5, p < 0.001). There were no differences in rates of post-operative concomitant therapy. Six patients who underwent rIMN (32%) received peri-operative radiation therapy which included knee joint at an average dose of 28.6 Gy. There were no documented cases of arthrofibrosis in the patients who received knee radiation. There were no differences in local recurrence, progression of disease, or revision surgeries across the cohorts (p > 0.05).
Conclusion:
The minimally invasive approach of rIMN for fixation of more distal lesions may have benefits of restoration of range of motion with low morbidity and mortality.
Level Of Evidence Iii:
Retrospective Cohort Study.
