A Single Proximal Interlocking Bolt May Be Sufficient for Retrograde Nailing of Extra-articular Femur Fractures

J Orthop Trauma. 2022 Dec 1;36(12):610-614. doi: 10.1097/BOT.0000000000002439.

Abstract

Objective: To evaluate whether a single proximal interlocking bolt was sufficient during the treatment of extra-articular femur fractures with retrograde medullary nailing.

Design: Retrospective comparative study.

Setting: Academic Level 1 trauma center.

Patients: The study included 136 patients with extra-articular femur fractures treated with retrograde medullary nailing who met inclusion and follow-up criteria.

Intervention: The intervention included surgical treatment for a femur fracture with retrograde medullary nailing, with comparisons made between those treated with a single proximal interlocking (1 IL) bolt and those treated with 2 proximal interlocking bolts (2 IL).

Main outcome measurement: The main outcome measurements were as follows: (1) rate of nonunion and (2) rate of catastrophic implant failure.

Results: There was no difference in the rate of nonunion requiring surgical intervention between the 2 groups. There were no catastrophic failures in either group.

Conclusions: A single proximal interlocking bolt may be sufficient when using retrograde nailing for the treatment of extra-articular femur fractures.

Level of evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

MeSH terms

  • Femoral Fractures* / etiology
  • Femoral Fractures* / surgery
  • Femur
  • Fracture Fixation, Intramedullary* / adverse effects
  • Humans
  • Retrospective Studies