Abstract
BackgroundThe objective of this study is to analyze the proximal tibiofibular joint in patients with knee pain after treatment of tibial shaft fractures with locked intramedullary nail.FindingsThe proximal tibiofibular joint was analyzed in 30 patients, who reported knee pain after tibial nailing, and standard radiograph and computed tomography were performed to examine the proximal third of the tibia. Twenty patients (68.9%) presented the proximal screw crossing the proximal tibiofibular joint and 13 (44.8%) had already removed the nail and/or screw. Four patients (13.7%) reported complaint of knee pain. However, the screw did not reach the proximal tibiofibular joint. Five patients (17.2%) complained of knee pain although the screw toward the joint did not affect the proximal tibiofibular joint.ConclusionWhen using nails with oblique proximal lock, surgeons should be careful not to cause injury in the proximal tibiofibular joint, what may be one of the causes of knee pain. Thus, the authors suggest postoperative evaluation performing computed tomography when there is complaint of pain.
Highlights
The objective of this study is to analyze the proximal tibiofibular joint in patients with knee pain after treatment of tibial shaft fractures with locked intramedullary nail
We retrospectively reviewed a hundred patients with displaced tibial shaft fractures treated with locked intramedullary nailing in a general hospital, between 2000 and 2004
Among a hundred patients treated with intramedullary nailing after tibial shaft fractures, 30% complained of knee pain
Summary
The objective of this study is to analyze the proximal tibiofibular joint in patients with knee pain after treatment of tibial shaft fractures with locked intramedullary nail. Tibial shaft fracture is considered the most common long bone in orthopaedic practice. Fixation with intramedullary nail has frequently been used and proven to be efficient in displaced tibial shaft fractures [1,2,3,4,5,6,7,8]. Tibial nailing is related with relatively low incidence of nonunion, malunion, infection and compartmental syndrome [9,10,11]. Pain in the knee joint is the most common complication after tibial nailing. The etiology of the knee pain after intramedullary nail is still unknown, many theories have been proposed [11,13,17,18,19]
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