Retrospective cohort study evaluating retrograde reamed femoral nailing as an alternative to standard antegrade nailing in 29 femoral shaft fractures across 24 patients, focusing on cases where antegrade access was compromised by ipsilateral pelvic or femoral neck injury, polytrauma positioning needs, or pregnancy.
When antegrade femoral nailing is contraindicated — ipsilateral acetabular or femoral neck fracture, polytrauma requiring simultaneous abdominal or pelvic access, or pregnancy — retrograde nailing through a medial condylar portal is a technically viable alternative with comparable healing rates and acceptable knee outcomes.
Watch for infraisthmal malreduction and insertion-site crack propagation as the primary intraoperative hazards.
Retrospective cohort study evaluating retrograde reamed femoral nailing as an alternative to standard antegrade nailing in 29 femoral shaft fractures across 24 patients, focusing on cases where antegrade access was compromised by ipsilateral pelvic or femoral neck injury, polytrauma positioning needs, or pregnancy.
When antegrade femoral nailing is contraindicated — ipsilateral acetabular or femoral neck fracture, polytrauma requiring simultaneous abdominal or pelvic access, or pregnancy — retrograde nailing through a medial condylar portal is a technically viable alternative with comparable healing rates and acceptable knee outcomes.
Watch for infraisthmal malreduction and insertion-site crack propagation as the primary intraoperative hazards.