Intramedullary Nailing in Femoral Diaphyseal Fractures: A Retrospective Multicenter Cohort Study
Intramedullary nails (IMNs) are the most frequent surgical fixation method for femur fractures. Although IMNs provide good healing outcomes and low complication rates, concerns persist regarding potential complications such as malunion, nonunion, and infections. This multicenter retrospective study...
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MDPI AG
2025-03-01
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| author | Fábio Lucas Rodrigues Ana Lya Moya Ferrari Fernando Ferraz Faria Rafael Luiz Emmanoel Pinto Manuela Fernandes Lopes Maria Eduarda Alencar Santos Evelyn Cardenas Varela Manuel Jucelino Lopes Filho Marianna Nogueira Cecyn Nelson Henrique Carvalho de Oliveira |
| author_facet | Fábio Lucas Rodrigues Ana Lya Moya Ferrari Fernando Ferraz Faria Rafael Luiz Emmanoel Pinto Manuela Fernandes Lopes Maria Eduarda Alencar Santos Evelyn Cardenas Varela Manuel Jucelino Lopes Filho Marianna Nogueira Cecyn Nelson Henrique Carvalho de Oliveira |
| author_sort | Fábio Lucas Rodrigues |
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| description | Intramedullary nails (IMNs) are the most frequent surgical fixation method for femur fractures. Although IMNs provide good healing outcomes and low complication rates, concerns persist regarding potential complications such as malunion, nonunion, and infections. This multicenter retrospective study aims to assess the epidemiology and outcomes of IMNs for diaphyseal femoral fractures. Data from 91 patients who underwent IMN fixation at two Brazilian hospitals between 2020 and 2024 were analyzed, with a mean age of 33.3 years (SD ± 12.7) and 76.9%% of male patients. Traffic accidents were the most common mechanism of trauma (84.61%). The bone healing rate was 96.7% within six months, and 98.9% within one year, with a complication rate of 3.26%, including two cases of pseudoarthrosis, one case of pseudoarthrosis and infection, and two reoperations. There was a significant association between previous external fixation and fracture type (open/closed) (χ<sup>2</sup>(1) = 17.5, p<sub>Fischer</sub> < 0.001). Previous external fixation was also associated with lower consolidation rates six months post-surgery (χ<sup>2</sup>(1) = 9.83, p<sub>Fischer</sub> = 0.031), but not after one year (χ<sup>2</sup>(1) = 8.19, p<sub>Fischer</sub> = 0.11). The retrograde approach was associated with a lower consolidation rate after six months (χ<sup>2</sup>(1) = 6.98, p<sub>Fischer</sub> = 0.027), but no significant association was found after one year (χ<sup>2</sup>(1) = 2.27, p<sub>Fischer</sub> = 0.308). Only one patient with pseudoarthrosis did not consolidate after one year. The outcomes support the efficacy of IMNs in achieving bone consolidation with low complication rates. |
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| spelling | doaj-art-d8835c8ae04b465aa42d039a4f39097a2025-08-20T02:18:19ZengMDPI AGLife2075-17292025-03-0115454010.3390/life15040540Intramedullary Nailing in Femoral Diaphyseal Fractures: A Retrospective Multicenter Cohort StudyFábio Lucas Rodrigues0Ana Lya Moya Ferrari1Fernando Ferraz Faria2Rafael Luiz Emmanoel Pinto3Manuela Fernandes Lopes4Maria Eduarda Alencar Santos5Evelyn Cardenas Varela6Manuel Jucelino Lopes Filho7Marianna Nogueira Cecyn8Nelson Henrique Carvalho de Oliveira9Orthopedics and Traumatology Residency Program, ABC Medical School, Santo André 09060-870, BrazilResearch and Development Department, Biomecanica, Jaú 17212-811, BrazilOrthopedics and Traumatology Residency Program, Cajuru University Hospital, Curitiba 80050-350, BrazilOrthopedics and Traumatology Residency Program, Cajuru University Hospital, Curitiba 80050-350, BrazilOrthopedics and Traumatology Residency Program, Adriano Jorge Hospital Foundation, Manaus 69079-015, BrazilOrthopedics and Traumatology Residency Program, Adriano Jorge Hospital Foundation, Manaus 69079-015, BrazilOrthopedics and Traumatology Residency Program, Adriano Jorge Hospital Foundation, Manaus 69079-015, BrazilOrthopedics and Traumatology Residency Program, Adriano Jorge Hospital Foundation, Manaus 69079-015, BrazilPaulista School of Medicine, Department of Psychobiology, Federal University of Sao Paulo, São Paulo 04724-000, BrazilOrthopedics and Traumatology Residency Program, Adriano Jorge Hospital Foundation, Manaus 69079-015, BrazilIntramedullary nails (IMNs) are the most frequent surgical fixation method for femur fractures. Although IMNs provide good healing outcomes and low complication rates, concerns persist regarding potential complications such as malunion, nonunion, and infections. This multicenter retrospective study aims to assess the epidemiology and outcomes of IMNs for diaphyseal femoral fractures. Data from 91 patients who underwent IMN fixation at two Brazilian hospitals between 2020 and 2024 were analyzed, with a mean age of 33.3 years (SD ± 12.7) and 76.9%% of male patients. Traffic accidents were the most common mechanism of trauma (84.61%). The bone healing rate was 96.7% within six months, and 98.9% within one year, with a complication rate of 3.26%, including two cases of pseudoarthrosis, one case of pseudoarthrosis and infection, and two reoperations. There was a significant association between previous external fixation and fracture type (open/closed) (χ<sup>2</sup>(1) = 17.5, p<sub>Fischer</sub> < 0.001). Previous external fixation was also associated with lower consolidation rates six months post-surgery (χ<sup>2</sup>(1) = 9.83, p<sub>Fischer</sub> = 0.031), but not after one year (χ<sup>2</sup>(1) = 8.19, p<sub>Fischer</sub> = 0.11). The retrograde approach was associated with a lower consolidation rate after six months (χ<sup>2</sup>(1) = 6.98, p<sub>Fischer</sub> = 0.027), but no significant association was found after one year (χ<sup>2</sup>(1) = 2.27, p<sub>Fischer</sub> = 0.308). Only one patient with pseudoarthrosis did not consolidate after one year. The outcomes support the efficacy of IMNs in achieving bone consolidation with low complication rates.https://www.mdpi.com/2075-1729/15/4/540intramedullary fracture fixationconsolidationfemoral fracturesdiaphysealshaftnail |
| spellingShingle | Fábio Lucas Rodrigues Ana Lya Moya Ferrari Fernando Ferraz Faria Rafael Luiz Emmanoel Pinto Manuela Fernandes Lopes Maria Eduarda Alencar Santos Evelyn Cardenas Varela Manuel Jucelino Lopes Filho Marianna Nogueira Cecyn Nelson Henrique Carvalho de Oliveira Intramedullary Nailing in Femoral Diaphyseal Fractures: A Retrospective Multicenter Cohort Study Life intramedullary fracture fixation consolidation femoral fractures diaphyseal shaft nail |
| title | Intramedullary Nailing in Femoral Diaphyseal Fractures: A Retrospective Multicenter Cohort Study |
| title_full | Intramedullary Nailing in Femoral Diaphyseal Fractures: A Retrospective Multicenter Cohort Study |
| title_fullStr | Intramedullary Nailing in Femoral Diaphyseal Fractures: A Retrospective Multicenter Cohort Study |
| title_full_unstemmed | Intramedullary Nailing in Femoral Diaphyseal Fractures: A Retrospective Multicenter Cohort Study |
| title_short | Intramedullary Nailing in Femoral Diaphyseal Fractures: A Retrospective Multicenter Cohort Study |
| title_sort | intramedullary nailing in femoral diaphyseal fractures a retrospective multicenter cohort study |
| topic | intramedullary fracture fixation consolidation femoral fractures diaphyseal shaft nail |
| url | https://www.mdpi.com/2075-1729/15/4/540 |
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