title: Comparison of effect of retrograde and antegrade approaches to interlocking nail fixation of femoral diaphyseal fractures on ipsilateral hip and knee joint motion.
abstract: OBJECTIVE
  The objective of this study was to evaluate the early impact of antegrade and retrograde interlocking nail fixation of femoral diaphyseal fractures on the ipsilateral hip and knee joint range of motion.
  
  
  METHODS
  A prospective evaluation was performed of 62 consecutive limbs with femoral diaphyseal fractures that had interlocking nail fixation through the antegrade or retrograde approaches. All participants had post-operative physiotherapy. Follow-up was for 9 months.
  
  
  RESULTS
  The mean maximum hip flexion angle at 9 months was 137.50 in the antegrade group and 133.80 in the retrograde group (p = 0.150). Trendelenburg test was negative in both groups and there was no knee extension lag at 9 months. While the mean maximum knee flexion angle at 9 months was 119.90 in the retrograde group and 134.50 in the antegrade group (p = 0.023). All patients had achieved radiologic and clinical fracture union by twenty four weeks post-operatively.
  
  
  CONCLUSIONS
  There was no significant effect of antegrade or retrograde approach on the range of motion of the hip joint. However, knee motion improved more quickly in the group that had antegrade nailing.
authors.affiliation: Department of Orthopaedic Surgery and Trauma, Obafemi Awolowo University Teaching Hospitals' Complex, Ile-Ife, Nigeria.
authors.forename: A M
authors.initials: AM
authors.lastname: Toluse
authors.forename: J E
authors.initials: JE
authors.lastname: Asuquo
authors.forename: I C
authors.initials: IC
authors.lastname: Ikem
authors.forename: O
authors.initials: O
authors.lastname: Esan
authors.forename: A L
authors.initials: AL
authors.lastname: Akinyoola
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails; D005260:Female; D005264:Femoral Fractures / Q000601:surgery*; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary; D006621:Hip Joint / Q000502:physiology*; D006801:Humans; D007719:Knee Joint / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology*; D016896:Treatment Outcome; D055815:Young Adult