A Longitudinal Observational Study of Gait Motion Post Femoral Nailing Operation: Antegrade vs. Retrograde Femoral Nailing

The purpose of this longitudinal observational study is to analyze gait data that quantifies human motion to determine if there is patterned differential gait outcomes between those undergoing antegrade vs. retrograde femoral nailing. Both methods treat femoral fractures via the insertion of a metal rod into the central cavity of the bone shaft to restore bone continuity; antegrade insertion occurs through the hip and retrograde insertion occurs through the knee. To estimate patient outcomes, we measured the maximum angle the knee can bend from full extension, i.e., knee flexion, as an indication of range of motion. We predict that retained knee flexion for those undergoing retrograde nailing incision will be comparatively worse than those undergoing antegrade nailing incision two weeks post-operation due to retrograde nailing insertion occurring via the knee. I extracted each patient’s two-week post-operation knee flexion measurements from their medical records, using the patient’s healthy knee as an indicator of original knee flexion prior to injury. The antegrade group retained an average of 65.38% of original knee flexion two weeks post-operation, whereas the retrograde group retained an average of 56.32% of original knee flexion. As the study remains ongoing, we are striving to increase enrollment to allow the use of parametric statistics to test the significance of these findings. We ultimately hope to employ a similar procedure using data from the Motion Analysis and Motor Performance Laboratory to determine global effects of antegrade vs. retrograde femoral nailing on the efficiency, kinematics, and force loads applied during typical walking.