Locked META intramedullary nailing fixation for tibial fractures via a suprapatellar approach

Abstract

Background:Intramedullary nailing is an effective approach for treatment of diaphyseal tibial fractures. However, infrapatellar intramedullary nailing can easily cause angulation and rotation displacement at the fracture ends and increase risk of postoperative infection. Intramedullary nailing via the suprapatellar approach was proved with good reduction and fixation. We used locked intramedullary nailing for the treatment of tibial fractures via a suprapatellar approach in this study.Materials and Methods:23 patients undergoing tibial fractures fixation by locked META intramedullary nailing via a suprapatellar approach were enrolled between June 2012 and October 2013. There were 18 males and 5 females. The average age was 35.5 years (range 18-60 years). The intraoperative data including operative time and blood loss and postoperative data consisting of hospital stays, fluoroscopy time, fracture healing time and complications were all recorded.Results:The average operative time, blood loss, fluoroscopy time and hospital stay were 78.2 ± 9.1 min, 90.4 ± 23.4 mL, 38.5 ± 6.5 s and 11 ± 3.4 days respectively. The mean followup period in all the patients was 15.5 months. Callus appeared in the patients at average 8 weeks after surgery. The mean knee and ankle range of motion were significantly improved at the last followup (P < 0.05). The average Hospital for Special Surgery and Olerud–Molander scores was 92 ± 4.3 points and 93.6 ± 3.9 points, respectively. No complications were observed.Conclusion:Locked META intramedullary nail fixation via a suprapatellar approach is safe and effective for patients suffering from tibial fractures and earlier functional recovery.

Comparison between computed tomography and magnetic resonance imaging in clinical diagnosis and treatment of tibial platform fractures

“…The general error is 2-3 mm, so it is only suitable for fracture screening[ 11 ]. According to clinical research, fractures generally occupy a three-dimensional space, and only two-dimensional plane observation has some limitations and cannot provide an accurate and reliable diagnostic basis for patients with compression, comminution and other fractures[ 12 ]. As a product of modern medical development, spiral CT can adequately compensate for the limitation of two-dimensional plane observation.…”

Suprapatellar approach for fractures of the tibia: Does the fracture level matter?

“…Tibial fractures are among the most common long bone fractures observed in the body. [1,2] Most tibial fractures are caused by either high-energy trauma, such as motor vehicle accidents, in young patients or low-energy trauma, such as falls, among older adults. Surgical treatment of tibial fractures via intramedullary nailing (IMN) is a common practice.…”

“…Surgical treatment of tibial fractures via intramedullary nailing (IMN) is a common practice. [1,[3][4][5] Intramedullary nailing is a biomechanical load-sharing device that has the potential advantages of early rehabilitation and weight bearing. [1,3,5] Intramedullary nailing also possesses other major benefits such as minimal soft tissue damage and preservation of extraosseous blood supply.…”

“…[1,[3][4][5] Intramedullary nailing is a biomechanical load-sharing device that has the potential advantages of early rehabilitation and weight bearing. [1,3,5] Intramedullary nailing also possesses other major benefits such as minimal soft tissue damage and preservation of extraosseous blood supply. [6,7] Recently, several techniques have been described for IMN of the tibia, including the medial parapatellar, lateral parapatellar, and transpatellar routes.…”

Trauma surgery – What is new in it?

“…They concluded that both methods are suitable for treatment, but the patients treated with intramedullary nails require more frequent re-operation to achieve union. In another article, Fu 4 describes suprapatellar approach for intramedullary nailing of tibia. The approach is described clearly in a simple manner.…”