Analysis of Retrograde Femoral Intramedullary Nail Placement Through Traumatic Knee Arthrotomies

Bible, Jesse E.; Kadakia, Rishin J.; Choxi, Ankeet A.; Bauer, Jennifer M.; Mir, Hassan R.

doi:10.1097/bot.0b013e318271b7bb

Cited by 6 publications

(5 citation statements)

References 11 publications

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“…In limbs with fractures fixed proximal to an amputation, the rate of infection has been reported to be 55% at the amputation site and 48% at both the amputation and the fracture site 12 . However, prior studies have shown no increased risk when placing either a tibial nail or a retrograde femoral nail through a contaminated traumatic knee arthrotomy 14,15 . Our patient sustained a deep infection, required several trips to the operating room, but ultimately had a good outcome.…”

Section: Discussionmentioning

confidence: 98%

Length-Preserving Intramedullary Femoral Fixation for Traumatic Leg Amputation

Bauer¹,

Callan²,

Jahangir³

2015

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Section: Discussionmentioning

confidence: 98%

Length-Preserving Intramedullary Femoral Fixation for Traumatic Leg Amputation

Bauer¹,

Callan²,

Jahangir³

2015

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“…Bible et al 20 compared 34 retrograde and 24 antegrade femoral nails in patients with ipsilateral traumatic knee arthrotomy. There were no cases of knee septic arthritis in the retrograde group and one case in the antegrade group.…”

Section: Discussionmentioning

confidence: 99%

A retrospective review of the rate of septic knee arthritis after retrograde femoral nailing for traumatic femoral fractures at a single academic institution

Bailey¹,

Nwadike²,

Revak³

2023

OTA International: The Open Access Journal of Orthopaedic Trauma

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Background:Retrograde intramedullary nailing of the femur is a popular treatment option for femoral shaft fractures. However, this requires accessing the intramedullary canal through the knee, posing a risk of intra-articular infection. The purpose of this study was to examine the rate of intra-articular infection of the knee after retrograde nailing of femoral shaft fractures.Methods:All patients who underwent retrograde intramedullary nailing for femoral shaft fractures between June 2004 and December 2017 at a level 1 trauma center were reviewed. Six months of follow-up or documented fracture union was required. Records were reviewed for documentation of septic arthritis of the ipsilateral knee during the follow-up period.Results:A total of 294 fractures, including 217 closed and 77 open injuries, were included. Eighteen had an associated ipsilateral traumatic arthrotomy; 188 cases had an associated ipsilateral lower extremity fracture. No cases of septic arthritis were identified.Conclusion:There were no cases of septic arthritis in 294 fractures treated with retrograde intramedullary nailing. Retrograde nailing appears safe for risk of postoperative septic arthritis of the knee even in the face of open fractures and traumatic wounds.

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“…Although a recent study by Bible et al [1] did not involve gunshot wounds, it compared 34 retrograde nailings to 24 antegrade nailings in patients with ipsilateral traumatic knee arthrotomies requiring irrigation and débridement. There were no cases of knee sepsis in the retrograde nailing group and one in the antegrade nailing group, leading the authors to conclude retrograde nailing was a relatively safe technique, even in the presence of a traumatic knee arthrotomy.…”

Section: Discussionmentioning

confidence: 99%

Retrograde Versus Antegrade Intramedullary Nailing of Gunshot Diaphyseal Femur Fractures

Dougherty

Gherebeh

Zekaj

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background The use of retrograde nailing for gunshot wound femur fractures is controversial due to concerns of knee sepsis after this procedure since the knee is entered to introduce the nail into the canal. Questions/purposes We compared retrograde and antegrade nailing for gunshot femur fractures to determine whether (1) knee sepsis or other adverse events were more likely to complicate procedures using retrograde nails, (2) there were differences in surgical time or blood loss, and (3) there were differences in radiographic union.Methods We retrospectively reviewed our prospective trauma database from 1999 to 2012 for patients with a diagnosis of gunshot and femur fracture. We performed a detailed review of medical records and radiographs for those patients with OTA Classification Type 32 femur fractures secondary to gunshot injury treated with either retrograde or antegrade femoral nailing. Eighty-one patients were treated with intramedullary nailing (53 retrograde and 28 antegrade). We reviewed elements of the operative treatment (procedure, anesthesia time, operative time, and estimated blood loss) for all 81 patients. For clinical and radiographic review, followup was adequate for 43 and 25 patients with retrograde and antegrade nailing, respectively. Minimum followup was 3 months for both groups (retrograde: mean, 41 months; range, 3-148 months; antegrade: 26 months: range, 3-112 months). Results No patients in either group developed knee sepsis. No significant differences were found between groups with regard to operative time, blood loss, or radiographic union. Conclusions With the numbers available, immediate retrograde nailing appears as safe and effective as antegrade nailing for gunshot femur fractures. Immediate retrograde nailing is as safe as antegrade nailing for gunshot femur fractures. Level of Evidence Level III, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.

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Analysis of Retrograde Femoral Intramedullary Nail Placement Through Traumatic Knee Arthrotomies

Cited by 6 publications

References 11 publications

Length-Preserving Intramedullary Femoral Fixation for Traumatic Leg Amputation

Length-Preserving Intramedullary Femoral Fixation for Traumatic Leg Amputation

A retrospective review of the rate of septic knee arthritis after retrograde femoral nailing for traumatic femoral fractures at a single academic institution

Retrograde Versus Antegrade Intramedullary Nailing of Gunshot Diaphyseal Femur Fractures

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