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Increased rate of union
7%
109/1587
Decreased rate of infection
2%
27/1587
Shorter operative time
15%
231/1587
Lower rates of hip pain
74%
1182/1587
Lower rates of knee pain
29/1587
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Patients with retrograde femoral nails commonly have knee pain, while antegrade nails commonly have hip pain, abductor weakness and heterotopic ossification of the abductors. Ostrum’s randomized prospective study of 100 patients with reamed femoral nails found 22% of antegrade nail patients had proximal hip pain, weak hip abductors or trendelenburg gait. No significant difference was found in set-up time, operative time, knee motion or pain, or infection rates. Ricci performed a retrospective study of 293 fractures and found that the antegrade femoral nail group had more hip pain (10% vs 4%) and the retrograde nail group had more knee pain (36% vs 9%). There was no difference in healing, malunion, non-union or other complications. Tornetta performed a randomized controlled comparison of 69 femur fractures and found more problems of length and rotation using a retrograde nailing. There was no difference in time to union, operating time, blood loss, complications, size of nail or reamer, or transfusion requirements.
3.3
(27)
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