Abstract
Objectives:To compare clinical efficacies of suprapatellar and infrapatellar intramedullary nailing approaches in treating tibial shaft fractures.Methods:Patients (n=110) admitted with tibial shaft fractures in our hospital from January 2017 to June 2020, who underwent procedures with internal fixation intramedullary nails, were retrospectively divided into suprapatellar and infrapatellar approach groups (n = 55 each) based on the surgical method used for fracture repair. The clinical and functional outcomes of the knee were assessed six months after the surgeryResults:Six months after the operation, the pooled value for excellent and good efficacy rates in the suprapatellar approach group, as indicated by Hospital for Special Surgery (HSS) Knee scoring system, was 90.91%, which was significantly higher than that in the infrapatellar approach group (76.36%). The degree of pain (visual analogue scale (VAS) score) of the patients in the suprapatellar approach group was over 2-fold lower than in the infrapatellar approach group (P < 0.001).The Lysholm knee score, range of motion (ROM), SF-36p, and SF-36M scores in the suprapatellar approach group were significantly higher than those in the infrapatellar approach group (P < 0.001).Conclusion:Suprapatellar approach had significantly higher clinical efficiency than infrapatellar approach, and can significantly reduce the degree of pain, promote the recovery of patients with knee joint involvement, improve the physical and psychological well-being, reduce the number of cases of postoperative delayed healing
Highlights
Tibial fracture is a common long bone fracture, mostly caused by high-energy impacts
The approach is a new operative method. This intramedullary nailing technique has gained acceptance for tibial shaft fractures, but the sharp instruments used during the operation may damage the articular surface and cartilage of the patella, and whether this or the infrapatellar technique has better specific curative effects is in dispute.[5,6]
Inclusion criteria were as follows: patients were diagnosed by X-ray as having unilateral tibial shaft fractures that could be treated with closed reduction and intramedullary nailing; fractures had occurred within 24 hours of the hospital admission; participants could tolerate the operation
Summary
Tibial fracture is a common long bone fracture, mostly caused by high-energy impacts. Intramedullary nailing through the infrapatellar route is the traditional technique, and the resulting internal fixation is relatively strong, allowing for the early exercise of patients; the operation is difficult, the patient’s position needs to be changed repeatedly, and the tibial shaft fracture reduction effect is imperfect.[3,4] The approach is a new operative method. This intramedullary nailing technique has gained acceptance for tibial shaft fractures, but the sharp instruments used during the operation may damage the articular surface and cartilage of the patella, and whether this or the infrapatellar technique has better specific curative effects is in dispute.[5,6] This study was designed to compare the efficacy and prognosis of supra- and infrapatellar intramedullary nailing techniques for the treatment of tibial shaft fractures
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