Retrograde Rodding Has Been Around for Years: Why are You Changing? - PowerPoint PPT Presentation

Nov 23, 2023 •17 likes •387 views

Retrograde Rodding Has Been Around for Years: Why are You Changing? I Get Results! Lisa K. Cannada, MD Disclosures No pertinent disclosures Member: AAOS Board of Directors MAOA Board of Directors OTA Committee Member Ortho

Retrograde Rodding Has Been Around for Years: Why are You Changing? I Get Results! Lisa K. Cannada, MD
Disclosures • No pertinent disclosures • Member: – AAOS Board of Directors – MAOA Board of Directors – OTA Committee Member
Ortho Jeopardy
Femur Fractures for $1000
The Answer: What is Retrograde Nailing?
While Others May be Struggling…
You Are Almost Done!
What is the role of retrograde nails in management of femur fractures today? Answer: Any and All!
INDICATIONS
Retrograde Nailing Bilateral Femur Fractures The Floating Knee
Retrograde Nailing Ipsilateral femoral neck fracture Ipsilateral operative pelvic or acetabular trauma
Retrograde Nailing Soft tissue trauma near insertion of antegrade nail Morbid Obesity
Retrograde Nailing Multiple trauma Severe trauma
Retrograde Nailing Preexisting hardware Need for increased distal fixation points
TECHNIQUE
Pre-Op Planning • Radiographic Evaluation • Fracture pattern amenable • Devise a plan to determine length and rotation
Positioning • Supine on table • Hip and knee draped free • Triangle or bolster under knee • Anesthesia help
Surgical Approach • Medial parapatellar or tendon splitting approach
Makes Your Case!
Another Reduction Aid
And if you Did Antergrade: Still Struggling…
COMPLICATIONS
Missed Femoral Neck Fractures: Much Worse if Antegrade • Treatment depends on timing of discovery • Adequate visualization BEFORE& AFTER case • Happens with both retrograde & antegrade
Dr. Zura: “It” Hurts
MYTHBUSTERS
YOU CAN’T RGN AN OPEN FEMUR FRACTURE
Conclusions/Myth Busted Relatively Low Rate of Knee Sepsis
YOU CAN’T RGN A GSW FEMUR FRACTURE
Conclusions/Myth Busted Relatively low incidence complications and deformity
WHAT ABOUT THE MISSED FEMORAL NECK FRACTURE?
Conclusions/Myth Busted No significant difference in missed FNF, but trend towards more missed…Always look!
YOU CAN’T RGN PROXIMAL FEMUR FRACTURES
Conclusions/Myth Busted Relatively low incidence complications and deformity
Conclusion • No significant difference in healing rate, op time, complications • Acceptable form of treatment for femoral shaft fractures
Even a Movie for This…
Thank You! Lcannada@slu.edu

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