Abstract
Intramedullary nailing of tibia fractures via asuprapatellar, transarticular approach with the knee joint in 20-30° of flexion and the use of specific protection tubes to preserve intra-articular structures. Extra-articular fractures of the proximal tibia; simple and comminuted fractures of the tibia diaphysis; segmental diaphyseal fractures of the tibia; extra-articular fractures of the distal tibia and fractures with simple intra-articular distal extension; floating knee injuries. Gustilo grade3C open fractures of the tibia; severe soft tissue laceration, contamination or infection in the suprapatellar area; ipsilateral knee joint prosthesis; knee arthrodesis; implants blocking the nail entry point. Via asuprapatellar, transarticular approach an intramedullary tibia nail is inserted after anatomical reposition of the tibial fracture with the knee joint in 20-30° of flexion. Use of specific protection tubes to preserve intra-articular structures. The proximal and distal locking configuration depends upon the specific fracture characteristics. In all, 61 patients underwent suprapatellar tibia nailing and were under follow-up at least until fracture union. Twelve patients suffered from an open fracture. A total of 17patients had adistal third fracture, 8sustained aproximal third fracture and 36 had ashaft fracture. Follow-up focused on patients with distal fractures; 6/17 patients sustained open fractures. Average time to union was 9weeks. One fracture did not heal and required exchange nailing. Two patients complained about anterior knee pain. Functionally, full range of motion was regained in all patients.
Published Version
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