Quantification of Anterior Cortical Bone Removal and Intermeniscal Ligament Damage at the Tibial Nail Entry Zone Using Parapatellar and Retropatellar Approaches

Bible, Jesse E.; Choxi, Ankeet A.; Dhulipala, Sravan; Evans, Jason M.; Mir, Hassan R.

doi:10.1097/bot.0b013e318283f675

Cited by 20 publications

(10 citation statements)

References 15 publications

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“…(26) anterior cortical defects are present with her the IM nail was placed in a infrapatellar or a suprapatellar technique. (27) Our study identified smoking as a predictor of knee pain. Ryan et al showed an inverse relationship between smoking and union 11 .…”

Section: Discussionmentioning

confidence: 77%

Character, Incidence, and Predictors of Knee Pain and Activity After Infrapatellar Intramedullary Nailing of an Isolated Tibia Fracture

2016

Journal of Orthopaedic Trauma

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Objective-To study the activity and incidence of knee pain after sustaining a isolated tibia fracture treated with an infrapatellar intramedullary nail at one year. Design-Retrospective review of prospective cohort Setting-Multicenter Academic and Community hospitals Patients-437 patients with an isolated tibia fracture completed a 12 month assessment on pain and self-reported activity. Intervention-Infrapatellar Intramedullary Nail Outcomes-Demographic information co-morbid conditions, injury characteristics, and surgical technique were recorded. Knee pain was defined on a 1-7 scale with 1 being "no pain" and 7 being a "very great deal of pain." Knee pain > 4 was considered clinically significant. Patients reported if they were "able", "able with difficulty" or "unable" to perform the following activities: kneel, run, climb stairs, and walk prolonged. Variables were tested in multilevel multivariable regression analyses. Results-Knee Pain: 11% percent of patients reported a "good deal" to a "very great deal" of pain (> 4). 52% of patients reported "no" or "very little" pain at 12 months. Activity at 12 months: 26% and 29% of patients were unable to kneel or run, respectively. 31% and 35% of patients respectively stated they were able with difficulty or unable to use stairs or walk.

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Section: Discussionmentioning

confidence: 77%

Character, Incidence, and Predictors of Knee Pain and Activity After Infrapatellar Intramedullary Nailing of an Isolated Tibia Fracture

2016

Journal of Orthopaedic Trauma

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“…After the introduction of the retro-patellar approach for tibial nailing, its safety was questioned and cadaveric studies were conducted. 8 , 20 In their study on adult cadavers, Bible et al 8 reported that the retro-patellar technique was a safe alternative with no meniscal or cruciate ligament injury – as in the parapatellar approach – and less inter-meniscal ligament injury. In their cadaveric study, Eastman et al 20 reported that the injury risks to the inter-meniscal ligament and the medial meniscus, which are comparable with the classical approach, could be prevented by avoiding excessive medial entry.…”

Section: Discussionmentioning

confidence: 99%

Retro-patellar approach in telescopic nailing of the tibia in children with osteogenesis imperfecta

Erdal¹,

Görgün²,

Sarıkaya³

et al. 2021

Journal of Children's Orthopaedics

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Purpose Telescopic intramedullary nailing (TN) has become the main choice of treatment in children with osteogenesis imperfecta (OI). The classical parapatellar tibial nailing technique poses difficulties in maintaining reduction, insertion of the nail and fluoroscopic imaging. Also, deformities of the proximal tibia in relatively small children with OI can be problematic for tibial nailing. In this report, we present the retro-patellar approach in tibial TN of children with OI as an alternative to the classical approach and report the early radiographic and clinical results of our patients. Methods The nail is inserted through a skin incision proximal to the patella, passing inside the patellofemoral joint while the knee is positioned to 15° to 20° of flexion. In total, 30 tibiae of 15 patients had been operated and were reviewed after at least one year of follow-up. Any complications, such as implant failure, joint damage or instability, malunion, nonunion or refracture, were recorded. Results The mean age of our patients was 8.5 years, and the mean follow-up period was 27 months. There were no complaints involving the knee. All patients showed complete union without any implant failure or refracture. We did not observe any nail protrusion, bending or loss of correction during the procedure. Conclusion The retro-patellar approach for tibial TN appears to be safe and effective in patients with OI. Level of Evidence IV

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“…The cannula used for suprapatellar nailing limits posterior translation of the starting guidewire at the level of the trochlea because the guidewire is centered within the cannula. This leads either to the guidewire entry site being forced anteriorly, which may lead to anterior translation of the starting point and increased reaming of the anterior tibial cortex, 18 or to the trajectory being forced posteriorly, which may lead to the nail displacing the fracture. (Figure 4) A simple solution to address this issue is to flex the knee more as this better exposes the starting point.…”

Section: Pearl 1: Semi-extended Positioningmentioning

confidence: 99%

Intramedullary Nailing of Periarticular Fractures

Virkus

Kempton

Sorkin

et al. 2018

J Am Acad Orthop Surg

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Plate fixation has historically been the preferred surgical treatment method for periarticular fractures of the lower extremity. This trend has stemmed from difficulties with fracture reduction and concerns of inadequate fixation with intramedullary implants. However, the body of literature on management of periarticular fractures of the lower extremities has expanded in recent years, indicating that intramedullary nailing of distal femur, proximal tibia, and distal tibia fractures may be the preferred method of treatment in some cases. Intramedullary nailing reliably leads to excellent outcomes when performed for appropriate indications and when potential difficulties are recognized and addressed.

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Quantification of Anterior Cortical Bone Removal and Intermeniscal Ligament Damage at the Tibial Nail Entry Zone Using Parapatellar and Retropatellar Approaches

Cited by 20 publications

References 15 publications

Character, Incidence, and Predictors of Knee Pain and Activity After Infrapatellar Intramedullary Nailing of an Isolated Tibia Fracture

Character, Incidence, and Predictors of Knee Pain and Activity After Infrapatellar Intramedullary Nailing of an Isolated Tibia Fracture

Retro-patellar approach in telescopic nailing of the tibia in children with osteogenesis imperfecta

Intramedullary Nailing of Periarticular Fractures

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