EVALUATION OF MID-LONG TERM RESULTS OF RETROGRADE INTRAMEDULLARY NAILING IN FEMORAL FRACTURES

OBJECTIVE: Femoral fractures require careful treatment, with retrograde intramedullary nailing being a minimally invasive method that preserves periosteal blood flow. This study evaluates the mid-to-long term outcomes of femoral fracture patients treated with retrograde intramedullary nailing. MATERIAL AND METHODS: In this retrospective study, 86 patients who underwent retrograde nailing for femoral fractures and had at least 2 years of follow-up were analyzed. Data on demographics, fracture characteristics, radiographs, union rates, and complications were examined. The range of motion (ROM) deficits in the contralateral limb, as well as coronal and sagittal malalignments and leg length discrepancies from final radiographs, were assessed. Pain and functional evaluations were done using the visual analog scale (VAS), Lower Extremity Functional Scale (LEFS), and Tegner Lysholm Knee Score (TLKS) during the final follow-up. RESULTS: The average loss of flexion in the knee joint was 7 ± 9 degrees, and the loss of extension was 3 ± 5 degrees. The average leg length discrepancy was 0.8 ± 1.1 cm. Coronal deformity averaged 4 ± 4 degrees, and sagittal deformity averaged 4 ± 3 degrees. The LEFS score was 69 ± 10, and the TLKS score was 82 ± 19. The preoperative VAS score was 9, which decreased to 2 postoperatively (p<0.0005). Union occurred in 92% of patients. Healing time was longer in multi-part fractures (p=0.044), with no significant difference in healing time between open and closed fractures (p=0.86). CONCLUSIONS: Retrograde intramedullary nailing provides satisfactory functional outcomes for femoral fractures. However, multi-part fractures result in prolonged healing times, and deformities and leg length discrepancies affect functional outcomes. Larger studies are needed to further assess the long-term results of retrograde nailing.ee replacement surgery performed under spinal anesthesia.