Summary
It appears that both the retrograde and antegrade approach to treating femoral shaft fractures yield high union and similar malunion rates. Those receiving antegrade nailing may heal faster although this was not consistent. Knee pain appears more common after retrograde nailing, whereas there were consistent findings in hip pain and heterotopic ossification predominating in those patients receiving antegrade nailing. Neither appears to significantly increase the risk of other complications. Functional outcomes cannot be determined.
