Comparative Study of Knee Functional Outcome And Associated Factors Of Patients Treated With Retrograde And Antegrade Nailing For Femur Shaft Fracture Done At Aabet Hospital Between 2018 To 2020 GC

Abstract

Abstract Background: Intramedullary nailing is currently preferred method of treating femoral shaft fracture as it provide stable fixation with excellent union rate(1). It also has advantages of decreased soft tissue stripping, lower rate of malalignment, leg length discrepancy, early ambulation, and decreased hospital stay(2). Among the possible ways of intramedullary nailing of femur shaft fracture, currently antegrade fashion is considered the gold standard but retrograde technique is also gaining acceptance recently. The emerging popularity of retrograde nailing is backed by several papers reporting similar functional outcomes with that of antegrade nailing.(3–5) These studies are done in setups with proper postoperative rehabilitation protocols which is not available in this study set up. Despite both retrograde and antegrade nailing is being done frequently in the study setup, there is no any study comparing the knee functional outcomes of both technique performed so far. Thus, the study has invaluable importance as it could help to develop guidelines and as a starting point for further studies Objective: To compare knee functional outcome and associated factors of patient with femoral shaft fracture treated with antegrade versus retrograde nail. Methods: Comparative Retrospective crossectional study was conducted on the knee functional outcome of patients treated by nailing for femur shaft fracture, done at AaBET hospital from Jan 2018 to Dec 2020. Data was collected by standardized questionnaires from patients coming for follow up and patient chart and Sign Surgery online Data base. Data entry and analysis was done using SPSS version 26. The study was conducted from November 2021 to May 2022. The total cost of the study is 27,250 Ethiopian Birr. Results: A total of 81 patients participated in the study. The mean WOMAC score of the Antegrade group is 9.32 with range of (0-23.9) while the that of the retrograde group is 14.99 with range of (0-32.3). In comparison, the retrograde group had significantly poorer functional outcome results than Antegrade group (p<0.001). There is a negative correlation between age and preoperative time with the knee functional outcome (p < .001). Conclusion: Retrograde nailing is associated with poorer knee scores in our patient population. Increasing age and preoperative time are factors associated with poorer scores.