Limited open reduction versus closed reduction in retrograde nailing for mid-distal femoral fractures

Compared with closed reduction, limited open reduction at the fracture plane in retrograde intramedullary nailing for mid-distal femoral shaft fractures offers significant advantages: it facilitates rapid insertion of the long guidewire, reduces the number of fluoroscopies, shortens operative time, decreases intraoperative blood loss, and minimizes intraoperative changes in the surgical strategy. Importantly, the limited open reduction does not increase incision-related complications or pain and does not affect knee joint function.