University of Texas Health Science Center at San Antonio (Dr. Johnson, Dr. Haus, Dr. Shah, Dr. Bankole, Dr. Hogue), San Antonio, TX, and the Harvard University (Dr. Hogue), Boston, MA.
J Am Acad Orthop Surg Glob Res Rev. 2020 Jun 1;4(6). doi: 10.5435/JAAOSGlobal-D-20-00065. eCollection 2020 Jun.
Retrograde and antegrade nailing techniques are the two options available to a surgeon when using elastic stable intramedullary nailing; however, the literature comparing these two nailing techniques is scarce. Thus, we conducted a retrospective review of all pediatric and adolescent ulnar fractures treated with elastic stable intramedullary nailing at our facility. We hypothesize that the clinical outcomes (implant and wound complications) and the time between surgery and radiographic union will be similar for both techniques.
A retrospective chart review of pediatric ulnar fracture patients treated at our facility was performed. Demographic and health information associated with the injury were collected, and the clinical outcomes of the two techniques were compared.
A total of 53 patients with 54 fractures were included in this study. Antegrade nail insertion was used to treat 59.2% fractures. Radiographic union was achieved in all patients. Nail insertion technique was not associated with postoperative wound complications, time to radiographic union or implant removal, or significant deficits in upper extremity rotation ( > 0.05). Antegrade nailing resulted in a symptomatic implantation 3.97 times more frequently than compared with retrograde nailing ( = 0.036).
Antegrade nailing demonstrates a similar healing profile but higher implant complications compared with the retrograde nailing technique in pediatric ulnar fractures.
当使用弹性稳定髓内钉时，外科医生有逆行和顺行两种钉技术可供选择；然而，比较这两种钉技术的文献很少。因此，我们对在我们机构接受弹性稳定髓内钉治疗的所有儿童和青少年尺骨骨折进行了回顾性研究。我们假设两种技术的临床结果（植入物和伤口并发症）和手术与影像学愈合之间的时间将相似。
对在我们机构接受治疗的小儿尺骨骨折患者进行了回顾性图表审查。收集了与损伤相关的人口统计学和健康信息，并比较了两种技术的临床结果。
本研究共纳入 53 例 54 处骨折患者。顺行钉插入术用于治疗 59.2%的骨折。所有患者均达到影像学愈合。钉插入技术与术后伤口并发症、影像学愈合时间或植入物去除时间或上肢旋转明显不足（>0.05）无关。与逆行钉相比，顺行钉导致症状性植入的发生率高 3.97 倍（=0.036）。
与逆行钉技术相比，顺行钉在儿童尺骨骨折中表现出相似的愈合特征，但植入物并发症更高。
