ArticleFrontiers in surgery2026
Comparison of retrograde vs. antegrade intramedullary nailing for extra-articular distal tibial fracture: a retrospective matched case-control study.
Article in Frontiers in surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To compare the clinical efficacy of retrograde vs. antegrade intramedullary nailing(RIN vs. AIN)for extra-articular distal tibial fracture. Methods: This retrospective matched case-control study included 42 patients treated between April 2020 and April 2024-21 with RIN and 21 with AIN. Patients were matched by age and sex. Perioperative parameters, radiographic reduction quality, malunion rate, time to weight-bearing, functional outcomes (Baird-Jackson and AOFAS scores), and complications were assessed. Pain at the knee and ankle was also recorded. All patients were followed for at least 12 months. A Results: Both groups had comparable baseline characteristics. RIN resulted in significantly lower intraoperative blood loss (34.38 ± 2.27 mL vs.49.38 ± 7.00 mL, Conclusion: Both RIN and AIN provide reliable fixation and satisfactory functional outcomes for extra-articular distal tibial fracture. RIN significantly reduces the incidence of anterior knee pain compared to AIN, a finding supported by adequate statistical power. RIN also reduces intraoperative blood loss and shortens hospital stay. The observed numerical advantage in excellent reduction requires further confirmation in larger, appropriately powered studies. RIN may be the preferred approach in selected patients, especially those with high functional demands or preexisting anterior knee pathology.
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