Intra-operative fluoroscopy time and radiation dose during suprapatellar tibial nailing versus infrapatellar tibial nailing

Williamson, Mike; Iliopoulos, Efthymios; Williams, R. Ryan; Trompeter, Alex

doi:10.1016/j.injury.2018.07.004

Cited by 38 publications

(22 citation statements)

References 12 publications

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“…Interestingly, a recent meta-analysis by Wang positioning whilst the knee was in a semi-flexed position [11]. Our meta-analysis does, however, include more, recently published high-quality studies [18,[20][21][22][23][24]. This data, when pooled, clearly show no difference in fluoroscopy time.…”

Section: Discussionmentioning

confidence: 85%

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Infrapatellar versus suprapatellar approach for intramedullary nailing of the tibia: a systematic review and meta-analysis

et al. 2021

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Background Intramedullary nailing (IMN) is a conventional technique for the treatment of tibial shaft fractures. It has been suggested that the suprapatellar (SP) approach holds advantages over the traditional infrapatellar (IP) approach. Current literature lacks adequate data to provide robust clinical recommendations. This meta-analysis aims to determine the efficacy of infrapatellar versus suprapatellar techniques for IMN. Methods An up-to-date literature search of the Embase, Medline, and registry platform databases was performed. The search was conducted using a predesigned search strategy and all eligible literature was critically appraised for methodological quality via the Cochrane’s collaboration tool. Fluoroscopy time, operative time, pain score, knee function, deep infection, non-union and secondary operation rates were all considered. Conclusion A total of twelve studies were included in the meta-analysis. The results of this analysis show that suprapatellar nailing is associated with reduced post-operative pain scores and improved functional outcomes. The data suggest no significant difference in terms of operative times, fluoroscopy times, rates of deep infection, non-union or secondary procedures when compared to infra-patellar techniques. Further studies are required to confirm these findings and assess long-term results.

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Section: Discussionmentioning

confidence: 85%

“…The fluoroscopy time was reported in 4 studies (n = 193) with high level of heterogeneity (I 2 = 87%) [7,11,16,20,24]. Comparison of SP to IP in terms of fluoroscopy time with random effect analysis was not significant (Fig.…”

Section: Outcome 1: Fluoroscopy Timementioning

confidence: 97%

Infrapatellar versus suprapatellar approach for intramedullary nailing of the tibia: a systematic review and meta-analysis

et al. 2021

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“…Tibial intramedullary nail placement can be achieved by both suprapatellar and infrapatellar access. The suprapatellar approach has more advantages than the infrapatellar approach[ 4 - 8 ]; however, how best to remove the nail via the original suprapatellar incision used for nail insertion is uncertain.…”

Section: Discussionmentioning

confidence: 99%

New method to remove tibial intramedullary nail through original suprapatellar incision: A case report

He¹,

Li²

2022

WJCC

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BACKGROUND Since 2006, introducing a tibial intramedullary nail via the suprapatellar approach has been established; however, nail removal must be carried out using classic infrapatellar access, which can lead to complications. Here, we report a new method to remove the intramedullary nail through the original suprapatellar incision. CASE SUMMARY A 39-year-old man was hit by a vehicle in 2019. He was immobilized with a 10-mm × 330-mm tibial intramedullary nail via the suprapatellar approach due to left middle tibial fracture. Two years later, the patient requested for the implant to be removed. We used a new method to remove the tibial intramedullary nail through the original suprapatellar incision, and the operation went smoothly. CONCLUSION This case report indicates that suprapatellar access can be used to remove the intramedullary nail via the original incision without infrapatellar access, thus avoiding surgical complications.

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“…An optimal surgical position facilitates surgical ow and exposure, shortens operation time, reduces bleeding, and protects the life of patients. There are some disadvantages to adopting the extreme knee exion position when using the infrapatellar approach, including di culty in observing the puncture point during surgery, loss of fracture reduction, and long duration of uoroscopy [15]. Although some investigators have attempted to solve these di culties using special intraoperative traction devices [18], they often require additional traction equipment, increase the cost of surgery, and extend operation time, making it di cult for more widespread use.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, supine with the knee hyper exed is necessary during tibial intramedullary nailing using the infrapatellar approach. This position has shortcomings including di culty in obtaining the proximal tibial anteroposterior view during intraoperative uoroscopy, easy loss of alignment after fracture reduction, and prolonged duration of uoroscopy [15].…”

Section: Introductionmentioning

confidence: 99%

Lateral Position: A Friendly Surgical Position for Intramedullary Nailing of Tibial Shaft Fractures Via Infrapatellar Approach

Zhao¹,

Qu²,

Tan³

et al. 2020

Preprint

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Purpose The purpose of this study was to investigate the utility of the lateral position in intramedullary nailing of tibial shaft fractures via the infrapatellar approach.Methods The present study was a retrospective analysis of 112 patients who sustained closed tibial shaft fractures and treated with intramedullary nailing via the infrapatellar approach. Patients were divided into two groups according to surgical position: lateral or supine. The demographic and clinical data were collected and analyzed. Results There were 54 patients in the lateral and 58 in the supine position groups. The duration of surgery and fluoroscopy was shorter in the lateral group than the supine group (p < 0.05). Blood loss during surgery was lower in the lateral compared with supine position group (p < 0.05). The malunion rate was lower in the lateral position group as compared with the supine position group (p < 0.05); moreover, fewer surgical assistants were needed than in the supine group (p < 0.05). There were no significant differences in fracture healing time, other complications between the two groups (p > 0.05). Conclusions The lateral position was a more convenient choice for intramedullary nailing of tibial shaft fractures via infrapatellar approach.

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Intra-operative fluoroscopy time and radiation dose during suprapatellar tibial nailing versus infrapatellar tibial nailing

Cited by 38 publications

References 12 publications

Infrapatellar versus suprapatellar approach for intramedullary nailing of the tibia: a systematic review and meta-analysis

Infrapatellar versus suprapatellar approach for intramedullary nailing of the tibia: a systematic review and meta-analysis

New method to remove tibial intramedullary nail through original suprapatellar incision: A case report

Lateral Position: A Friendly Surgical Position for Intramedullary Nailing of Tibial Shaft Fractures Via Infrapatellar Approach

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