No Evidence of Infection After Retrograde Nailing of Supracondylar Femur Fracture in Gunshot Wounds

Poyanlı, Oğuz; Unay, Koray; Akan, Kaya; Güven, Melih; Özkan, Korhan

doi:10.1097/ta.0b013e3181bb974b

Cited by 16 publications

(12 citation statements)

References 19 publications

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“…6 Retrograde nail insertion does not seem to have a detrimental effect on knee function and does not increase the risk for knee sepsis. 7,8 During external fixator application in the femur, most problems occur around the proximal pins because of the bulky soft tissues. To decrease pin site problems, we prefer retrograde nailing, which allows the use of a single Schanz pin at the proximal thigh.…”

Section: Discussionmentioning

confidence: 99%

Lengthening Over a Retrograde Nail Using 3 Schanz Pins

Küçükkaya¹,

Karakoyun²,

Kuzgun³

2012

Journal of Orthopaedic Trauma

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The technique of lengthening over an antegrade nail is used widely for distraction osteogenesis of the femur. Most reported complications of this technique are related to Schanz pins. We hypothesized that reducing the number of Schanz pins would enable successful distraction with fewer complications. To this purpose, we describe a new technique for lengthening over a retrograde nail using only 1 proximal and 2 distal Schanz pins.

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Section: Discussionmentioning

confidence: 99%

Lengthening Over a Retrograde Nail Using 3 Schanz Pins

Küçükkaya¹,

Karakoyun²,

Kuzgun³

2012

Journal of Orthopaedic Trauma

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“…To be able to use this device with gunshot femur fractures may be an advantage in certain cases. We are aware of only two clinical case series of retrograde IM nailing for gunshot femur fractures [2,9] but none comparing retrograde and antegrade nailing for patients with gunshot femur fractures. To our knowledge, our study is the first to compare the two groups with regard to the end points of knee sepsis and other complications, anesthetic and operative times, blood loss, and fracture union.…”

Section: Discussionmentioning

confidence: 99%

“…Poyanli et al [9] performed a retrospective review of 15 patients with supracondylar gunshot wounds treated with short retrograde nails for an average followup of 11.7 years. Eight of the patients had military rifle wounds, whereas seven were from handguns.…”

Section: Discussionmentioning

confidence: 99%

“…Initially, a gunshot fracture was considered a relative contraindication for treatment using retrograde IM nailing due to concerns about the possibility of knee sepsis [8,9]. Knee sepsis, either directly from the entry point itself or via communication from the open medullary canal after nail insertion, was thought to be a possible means of contamination.…”

Section: Introductionmentioning

confidence: 99%

“…One study of 15 patients with supracondylar femur fractures (defined as high velocity or low velocity) treated with a short IM nail reviewed the outcomes an average of 14 months after injury [9]. A second retrospective review was performed on 73 patients with 74 low-velocity gunshot femur fractures [2].…”

Section: Introductionmentioning

confidence: 99%

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Retrograde Versus Antegrade Intramedullary Nailing of Gunshot Diaphyseal Femur Fractures

Dougherty

Gherebeh

Zekaj

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background The use of retrograde nailing for gunshot wound femur fractures is controversial due to concerns of knee sepsis after this procedure since the knee is entered to introduce the nail into the canal. Questions/purposes We compared retrograde and antegrade nailing for gunshot femur fractures to determine whether (1) knee sepsis or other adverse events were more likely to complicate procedures using retrograde nails, (2) there were differences in surgical time or blood loss, and (3) there were differences in radiographic union.Methods We retrospectively reviewed our prospective trauma database from 1999 to 2012 for patients with a diagnosis of gunshot and femur fracture. We performed a detailed review of medical records and radiographs for those patients with OTA Classification Type 32 femur fractures secondary to gunshot injury treated with either retrograde or antegrade femoral nailing. Eighty-one patients were treated with intramedullary nailing (53 retrograde and 28 antegrade). We reviewed elements of the operative treatment (procedure, anesthesia time, operative time, and estimated blood loss) for all 81 patients. For clinical and radiographic review, followup was adequate for 43 and 25 patients with retrograde and antegrade nailing, respectively. Minimum followup was 3 months for both groups (retrograde: mean, 41 months; range, 3-148 months; antegrade: 26 months: range, 3-112 months). Results No patients in either group developed knee sepsis. No significant differences were found between groups with regard to operative time, blood loss, or radiographic union. Conclusions With the numbers available, immediate retrograde nailing appears as safe and effective as antegrade nailing for gunshot femur fractures. Immediate retrograde nailing is as safe as antegrade nailing for gunshot femur fractures. Level of Evidence Level III, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.

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