Suprapatellar Intramedullary Nail Technique Lowers Rate of Malalignment of Distal Tibia Fractures

Abstract

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Comparison of suprapatellar versus infrapatellar approaches of intramedullary nailing for distal tibia fractures

“…The rate of malalignment in the SP group (4.8%, 2/42) was signi cantly lower than that in the IP group (14.3%, 8/56). Our results are consistent with the result of a previous study reporting the radiographical outcomes following the treatment of distal tibia fractures using the SP and IP approaches [24]. Frank R compared the radiographical outcomes following the treatment with IMN using the SP and IP approaches and reported that there was a 26.1% incidence of angular deformity greater than 5 degrees when IMN insertion was performed using the IP approach.…”

Intramedullary Nailing of Periarticular Fractures

“…Although originally described for proximal tibial nailing, semi-extended positioning of the leg during IMN improves clinical and fluoroscopic evaluation of the distal tibia, leading to low rates of malalignment. 14,33 Various semi-extended approaches are covered in detail in the proximal tibia section above.…”

“…In contrast, the semi-extended IMN technique has shown much more favorable results. 14,29,33 A recent retrospective review by Avilucea, et al demonstrated a 3.8% rate of malalignment in distal tibia fractures treated with a suprapatellar approach compared to a 26.1% rate of malalignment in those treated with an infrapatellar approach. 33 intraoperative malalignment.…”

“…14,29,33 A recent retrospective review by Avilucea, et al demonstrated a 3.8% rate of malalignment in distal tibia fractures treated with a suprapatellar approach compared to a 26.1% rate of malalignment in those treated with an infrapatellar approach. 33 intraoperative malalignment. 4,14,25,26,29,33,40 Therefore, success with extreme nailing hinges on the planning and execution of intraoperative strategies to effect an acceptable reduction.…”

“…33 intraoperative malalignment. 4,14,25,26,29,33,40 Therefore, success with extreme nailing hinges on the planning and execution of intraoperative strategies to effect an acceptable reduction.…”