Suprapatellar nailing of tibial fractures

Brink, Ole

doi:10.1097/bco.0000000000000308

Cited by 30 publications

(30 citation statements)

References 9 publications

(16 reference statements)

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“…The infrapatellar position made it difficult to perform a fluoroscopy during the surgical procedure. Capturing the orthogonal view of tibia was much easier with knee in semi-extended position, and this position may simplify the reduction of the fracture [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of suprapatellar and infrapatellar intramedullary nailing for tibial shaft fractures: a systematic review and meta-analysis

Yang

Sun

2018

J Orthop Surg Res

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BackgroundOptimal surgical approach for tibial shaft fractures remains controversial. We perform a meta-analysis from randomized controlled trials (RCTs) to compare the clinical efficacy and prognosis between infrapatellar and suprapatellar intramedullary nail in the treatment of tibial shaft fractures.MethodsPubMed, OVID, Embase, ScienceDirect, and Web of Science were searched up to December 2017 for comparative RCTs involving infrapatellar and suprapatellar intramedullary nail in the treatment of tibial shaft fractures. Primary outcomes were blood loss, visual analog scale (VAS) score, range of motion, Lysholm knee scores, and fluoroscopy times. Secondary outcomes were length of hospital stay and postoperative complications. We assessed statistical heterogeneity for each outcome with the use of a standard χ2 test and the I2 statistic. The meta-analysis was undertaken using Stata 14.0.ResultsFour RCTs involving 293 participants were included in our study. The present meta-analysis indicated that there were significant differences between infrapatellar and suprapatellar intramedullary nail regarding the total blood loss, VAS scores, Lysholm knee scores, and fluoroscopy times.ConclusionSuprapatellar intramedullary nailing could significantly reduce total blood loss, postoperative knee pain, and fluoroscopy times compared to infrapatellar approach. Additionally, it was associated with an improved Lysholm knee scores. High-quality RCTs were still required for further investigation.

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Section: Discussionmentioning

confidence: 99%

Comparison of suprapatellar and infrapatellar intramedullary nailing for tibial shaft fractures: a systematic review and meta-analysis

Yang

Sun

2018

J Orthop Surg Res

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“…One of the causes of malalignment which was observed more during postoperative period in the present study may be due to the procedure performed at knee flexion in all cases. The intramedullary nailing with suprapatellar insertion which is preferred during recent years is performed at semi-extension position (14). We believe that this new approach will be preferred more in the future since the ankle and distal side of the tibia can be imaged easier at semi-extension position.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the distal tibial fractures treated with intramedullary nailing in terms of malalignment

Yüksel

2018

Adıyaman Üniversitesi Sağlık Bilimleri Dergisi

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Background: The aim of the present study was to evaluate outcomes of distal tibia fractures AO/OTA 43 A1, A2, A3 whom we have treated through intramedullary nailing especially for alignment disorders. Materials and Methods: Fifty-five patients with distal tibia fractures AO/OTA type 43A1, A2, A3 (38 males, 17 females, mean age 41.3±15.3 years, mean follow-up period 35.1±9 weeks) who were treated through intramedullary nailing were evaluated retrospectively. Fracture union status, union time, complications and alignment disorders of the patients were evaluated. Olerud-Molander score was used for clinical evaluation. Results: Union was achieved in all patients. Mean Olerud-Molander score was 88.5 ± 8. Mean varus angle was 0.6 ± 1.4°, mean valgus angle was 2.1 ± 1.9°, mean recurvatum angle was 0.7 ± 1.2°, mean procurvatum angle was 0.3 ± 0.7°, mean rotation angle was 0.5 ± 1.4°. Two patients (3.6%) had varus malunion; 6 patients (10.9%) had valgus malunion, 1 patient (1.8%) had recurvatum malunion and 3 patients (5.5%) had rotation malunion. Conclusion: Successful results are obtained by intramedullary nailing treatment of distal tibia fractures. However, alignment problems, valgus alignment disorder in particular are not a rare complication (10.9%). A careful evaluation during surgical treatment and different techniques may help to prevent this complication.

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“…In conjunction with careful selection of a correct starting point, we utilize three methods to aid in proper reduction and counteract deformity forces: a suprapatellar approach with the leg in a semi-extended position [13], limited open reduction and provisional fixation with one or two one-third 3.5 mm plates [10], and the use of blocking (poller) screws to direct the path of the nail and facilitate proper reduction [14].…”

Section: Intramedullary Nailing Of Far-proximal Tibial Fracturesmentioning

confidence: 99%

“…It also results very useful for expeditious reduction and nailing of distal fractures and facilitates intraoperative fluoroscopy (Figure 2). As cited before, special instrumentation is required, and careful selection of the entry point and initial trajectory of the guide must be verified [10,13].…”

Section: Intramedullary Nailing Of Far-proximal Tibial Fracturesmentioning

confidence: 99%

“…Although some authors have reported better alignment indexes when using the suprapatellar approach, others have found that good alignment occurs also with the infrapatellar technique [21]. Various reduction techniques can be used for proper intraoperative reduction: percutaneous reduction clamps [22], limited direct open reduction [23], traction by means of a femoral distractor or by the assistant surgeon, and possibly the use of a suprapatellar approach [13]. In any case, during the procedure, insertion of the intramedullary guide should follow the center of the distal fragment in both anteroposterior and lateral fluoroscopy views [21,24].…”

Section: Intramedullary Nailing Of Far-distal Tibial Fracturesmentioning

confidence: 99%

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Far Proximal and Far Distal Tibial Fractures: Management with Intramedullary Nails

Bahamonde¹,

Zamorano²,

Zecchetto³

2020

Tibia Pathology and Fractures

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Operative treatment of tibial fractures located at the proximal metaphysealepiphyseal and distal metaphyseal-epiphyseal areas, including those with articular extensions, is a technical challenge. Common methods for surgical management include plates (locking and nonlocking), external fixation devices, and intramedullary nails. All these methods have shown satisfactory results in terms of quality of reduction and clinical and radiological outcomes. The authors present some technical methods and strategies that have been useful for the surgical approach, reduction, and fixation of these lesions with the use of locked nails.

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Suprapatellar nailing of tibial fractures

Cited by 30 publications

References 9 publications

Comparison of suprapatellar and infrapatellar intramedullary nailing for tibial shaft fractures: a systematic review and meta-analysis

Comparison of suprapatellar and infrapatellar intramedullary nailing for tibial shaft fractures: a systematic review and meta-analysis

Evaluation of the distal tibial fractures treated with intramedullary nailing in terms of malalignment

Far Proximal and Far Distal Tibial Fractures: Management with Intramedullary Nails

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