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

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

Nov 23, 2023 17 likes •391 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

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Retrograde Rodding Has Been Around for Years: Why are You Changing? I Get Results!

Lisa K. Cannada, MD

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Disclosures

  • No pertinent disclosures
  • Member:

– AAOS Board of Directors – MAOA Board of Directors – OTA Committee Member

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Ortho Jeopardy

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Femur Fractures for $1000

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The Answer: What is Retrograde Nailing?

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While Others May be Struggling…

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You Are Almost Done!

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What is the role of retrograde nails in management of femur fractures today?

Answer: Any and All!

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INDICATIONS

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Retrograde Nailing

Bilateral Femur Fractures The Floating Knee

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Retrograde Nailing

Ipsilateral femoral neck fracture Ipsilateral operative pelvic or acetabular trauma

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Retrograde Nailing

Soft tissue trauma near insertion of antegrade nail Morbid Obesity

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Retrograde Nailing

Multiple trauma Severe trauma

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Retrograde Nailing

Preexisting hardware Need for increased distal fixation points

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TECHNIQUE

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Pre-Op Planning

  • Radiographic

Evaluation

  • Fracture pattern

amenable

  • Devise a plan to

determine length and rotation

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Positioning

  • Supine on table
  • Hip and knee draped

free

  • Triangle or bolster

under knee

  • Anesthesia help
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Surgical Approach

  • Medial parapatellar
  • r tendon splitting

approach

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Makes Your Case!

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Another Reduction Aid

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And if you Did Antergrade: Still Struggling…

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COMPLICATIONS

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Missed Femoral Neck Fractures: Much Worse if Antegrade

  • Treatment depends on

timing of discovery

  • Adequate visualization

BEFORE& AFTER case

  • Happens with both

retrograde & antegrade

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  • Dr. Zura: “It” Hurts
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MYTHBUSTERS

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YOU CAN’T RGN AN OPEN FEMUR FRACTURE

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Conclusions/Myth Busted

Relatively Low Rate of Knee Sepsis

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YOU CAN’T RGN A GSW FEMUR FRACTURE

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Conclusions/Myth Busted

Relatively low incidence complications and deformity

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WHAT ABOUT THE MISSED FEMORAL NECK FRACTURE?

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Conclusions/Myth Busted

No significant difference in missed FNF, but trend towards more missed…Always look!

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YOU CAN’T RGN PROXIMAL FEMUR FRACTURES

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Conclusions/Myth Busted

Relatively low incidence complications and deformity

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Conclusion

  • No significant

difference in healing rate, op time, complications

  • Acceptable form of

treatment for femoral shaft fractures

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Even a Movie for This…

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Thank You!

Lcannada@slu.edu