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

Avilucea, Frank R.; Triantafillou, Kostas; Whiting, Paul S.; Perez, Edward A.; Mir, Hassan R.

doi:10.1097/bot.0000000000000631

Cited by 100 publications

(99 citation statements)

References 20 publications

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“…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.…”

Section: Discussionsupporting

confidence: 91%

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

Wang

et al. 2020

Preprint

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Background: This study aimed to analyze and compare the clinical and functional outcomes of distal tibia fractures treated with intramedullary nailing (IMN) using the suprapatellar (SP) and infrapatellar (IP) surgical approaches.Methods: A retrospective analysis was performed in 63 patients with distal fractures that were treated with IMN between August 2014 and August 2018. A total of 27 and 36 patients underwent IMN using the SP and IP techniques, respectively. The surgical time, blood loss, closed reduction rate, rate of adjuvant reduction technique, fracture healing time, and complications were reviewed in this study. Anterior knee pain was assessed using the visual analog scale. The Lysholm Knee Scoring Scale and American Orthopaedic Foot and Ankle Society (AOFAS) scale were used as clinical measurements.Results: A total of 63 patients, with a minimum follow-up of 12 months, were evaluated. The average surgical time, blood loss, rate of adjuvant reduction technique, closed reduction rate, fracture healing time, and Lysholm Knee Scoring Scale score were insignificantly different (P>0.05) between the two groups. However, the SP approach was superior to the IP approach in terms of pain score, AOFAS score, and fracture deformity rate (P<0.05).Conclusions: In the treatment of distal tibia fractures, the SP IMN technique is associated with a significantly higher functional outcome, lower knee pain, and lower rate of fracture deformity than the IP IMN technique.

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Section: Discussionsupporting

confidence: 91%

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

Wang

et al. 2020

Preprint

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“…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.…”

Section: Pearl 5: Semi-extended Positioningmentioning

confidence: 99%

“…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.…”

Section: Distal Tibia Literaturementioning

confidence: 99%

“…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.…”

Section: Distal Tibia Literaturementioning

confidence: 99%

“…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.…”

Section: Distal Tibia Literaturementioning

confidence: 99%

See 2 more Smart Citations

Intramedullary Nailing of Periarticular Fractures

Virkus

Kempton

Sorkin

et al. 2018

J Am Acad Orthop Surg

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Plate fixation has historically been the preferred surgical treatment method for periarticular fractures of the lower extremity. This trend has stemmed from difficulties with fracture reduction and concerns of inadequate fixation with intramedullary implants. However, the body of literature on management of periarticular fractures of the lower extremities has expanded in recent years, indicating that intramedullary nailing of distal femur, proximal tibia, and distal tibia fractures may be the preferred method of treatment in some cases. Intramedullary nailing reliably leads to excellent outcomes when performed for appropriate indications and when potential difficulties are recognized and addressed.

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The Interlocking Nailing System and Technique

Gill

Khatun

Khan

2019

General Principles of Orthopedics and Trauma

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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.

Cited by 100 publications

References 20 publications

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

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

Intramedullary Nailing of Periarticular Fractures

The Interlocking Nailing System and Technique

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