Toluse A M, Ikem I C, Akinyoola A L, Esan O, Asuquo J E
Department of Orthopaedic Surgery and Trauma, Obafemi Awolowo University Teaching Hospitals' Complex, Ile- Ife, Nigeria.
Niger Postgrad Med J. 2015 Mar;22(1):41-4.
Antegrade reamed interlocked intramedullary nailing is the treatment of choice forfemoral diaphyseal fractures. More recently, retrograde intramedullary nailing of the femur has been seen as a viable alternative to the antegrade nail.
This was a prospective comparative study. Consecutive patients were placed alternately into a study group (retrograde nailing) and a control group (antegrade nailing) in a ratio of 2:1 i.e two retrograde nailing for every antegrade nailing. Forty one fractures had interlocking intramedullary fixation via the retrograde approach (study group), while the control group consisted of twenty fractures that had fixation via the antegrade approach. All were followed up for a minimum period of nine months (range of nine to twenty-four months).
The mean duration of surgery in the retrograde group was 157.07minutes and 137.40 minutes in the antegrade group (p=0.093). The mean duration to fracture union was 16.98±4.71 weeks in the retrograde group and 15.80±5.43 weeks in the antegrade group (p = 0.388). There was no incidence of non-union in the two groups.
Retrograde approach compares favourably with antegrade approach for intramedullary interlocking nail fixation of diaphyseal femoral fracture in adults with respect to time of fracture healing.
顺行扩髓带锁髓内钉是股骨干骨折的首选治疗方法。最近，股骨逆行髓内钉已被视为顺行髓内钉的一种可行替代方法。
这是一项前瞻性比较研究。连续的患者按2:1的比例交替纳入研究组（逆行髓内钉固定）和对照组（顺行髓内钉固定），即每例顺行髓内钉固定对应两例逆行髓内钉固定。41例骨折采用逆行入路进行带锁髓内固定（研究组），而对照组由20例采用顺行入路进行固定的骨折患者组成。所有患者均随访至少9个月（9至24个月）。
逆行组的平均手术时间为157.07分钟，顺行组为137.40分钟（p = 0.093）。逆行组骨折愈合的平均时间为16.98±4.71周，顺行组为15.80±5.43周（p = 0.388）。两组均无骨不连发生。
在成人股骨干骨折的髓内带锁钉固定方面，就骨折愈合时间而言，逆行入路与顺行入路相比具有优势。
