Does Retrograde Femoral Nailing through a Normal Physis Impair Growth?

The insertion of an intramedullary nail may be beneficial in certain cases of leg length discrepancy or management of femoral fractures in children. However, it is unknown if the physeal injury due to the surgery may cause bone bridge formation and thereby growth arrest after removal. This study aimed to assess longitudinal interphyseal growth 16 weeks after insertion and later removal of a retrograde femoral nail passing through the physis in an experimental porcine model. 
No difference in longitudinal growth was observed when comparing the operated femur to the non-operated femur using MRI after 16 weeks. No osseous tissue crossing the physis was observed on MRI or histology. 

The insertion of a retrograde intramedullary femoral nail centrally through the physis and later removal might be safe, however, long-term follow-up is needed.

Read the article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8311745/