Outcomes Of Femoral Mid-shaft Fractures:A Retrospective Comparative Study Between Antegrade Intramedullary Nail And Retrograde Intramedullary Nail

Background:Femoral mid-shaft fractures can be straight forward injury;femur is very strong,there is no evidence of bimodal age characteristics,so in a healthy bone injury mostly results from high energy trauma like road traffic accidents or high distance fall both young and elderly patients,osteoporotic bone fractures are associated with less energy trauma.Intramedullary nailing is used worldwide both antegrade and retrograde,although the advantages and postoperative complication rates are similar for both implants,they both tend to have high union rates and low morbidity.Objectives:The aim of this study is to compare antegrade nail with a retrograde nail,by investigating the intro & post-operative outcomes;including union,mal-union and complication rates of surgically treated adult femur mid-shaft fracture patients.Methods:Our clinical records and radiographic data for all adult femoral mid-shaft fracture patients surgically treated either with antegrade and retrograde IMN from July 2014 to September 2018 were retrospectively reviewed and collected for analysis.30 patients were fixed with antegrade IMN and 30 with retrograde IMN.Gender,implant removal,complication rates as well as other pre,intra,postoperative characteristics were assessed to find out any difference between retrograde and antegrade groups.Result:Sixty cases were evaluated(30 in the antegrade group and 30 in the retrograde group).The two groups were alike regarding their age,sex,mechanism of injury,injury side,fracture pattern,and associated injuries.The patients in the antegrade group showed male predominance(p=0.039)and the retrograde group showed higher Implant removal(p=0.024).The complication rate was not significantly different in the different operative groups(p=1.000).Conclusion:Femoral mid-shaft adult fractures can be treated with either antegrade intramedullary nail or retrograde intramedullary nail.Even though our study couldn't yield a significant statistical difference in union and complication rates between retrograde and antegrade,Male predominance was evident in the antegrade group.