Suprapatellar Versus Infrapatellar Tibial Nail Insertion

Chan, Daniel Shiu‐Hin; Serrano-Riera, Rafael; Griffing, Rebecca; Steverson, Barbara; Infante, Anthony; Watson, David; Sagi, H. Claude; Sanders, Roy

doi:10.1097/bot.0000000000000499

Cited by 116 publications

(146 citation statements)

References 17 publications

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“…However, the previous studies showed different results compared to our studies [13,14] [22]. Moreover, Aksahin et al [26] found that the damage to quadriceps might worsen the patellar tilt due to the sagittal patellar tilt and quadriceps hypotrophy after tibial nailing, besides, the displacement of patella might have a negative impact on the knee function.…”

Section: Resultscontrasting

confidence: 74%

“…However, for the HSS component, our study showed that the IP approach was superior to SP approach with respect to the range of motion.Evaluation of the overall HSS knee score of SP and IP approaches for the treatment of tibial shaft fracture in this study demonstrated comparable outcomes. Our results are in line with the previous data reporting comparable functional knee outcomes between SP and IP approaches[14,15]. Chan DS et al compare the clinical outcomes of the knee joint after SP versus IP tibial nail insertion in a prospective randomized study with 42 patients and 12 months of follow-up, and reported no…”

supporting

confidence: 92%

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Suprapatellar versus infrapatellar approaches in the treatment of tibia intramedullary nailing ： A retrospective cohort study

Cui

Hua

Schmidutz

et al. 2019

Preprint

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Background: Tibial shaft fractures are routinely managed with intramedullary nailing (IMN). An increasingly accepted technique is the suprapatellar (SP) approach. The purpose of this study was to compare the clinical and functional outcomes of knee joint after tibia IMN through an suprapatellar (SP) or traditional infrapatellar (IP) approach. Methods: Retrospective analysis was performed in patients with tibial shaft fractures that were treated with IMN through a SP or IP approach between 01/01/2014 and 31/12/2016. The clinical and functional outcomes of the knee were assessed with the Hospital for Special Surgery (HSS) Knee Score. Secondary outcomes included the operation time and intraoperative blood loss. Results: A total of 50 patients/fractures (26 IP and 24 SP) with a minimum follow-up of 15 months were evaluated. All fractures were OTA 42. No significant differences were found between the two groups in age, gender, side of fractures, operation time, intra-operative blood loss, and follow-up time. No significant difference was seen in HSS score ( P = 0.62) between them. Sub analysis of all the HSS components scores revealed no significant differences between pain ( P = 0.57), the stand and walk ( P = 0.54), the need for walking stick ( P = 0.60) and extension lag ( P = 0.60). The other HSS components showed full scores (IP 10 vs. SP 10) in both approaches, including muscle force, flexion deformity and stability components. The range of motion (ROM) component score was superior in the IP group ( P = 0.04) suggesting a higher ROM. Conclusions: Both SP and IP approach results in equivalent overall HSS knee scores. However, for the HSS component, the IP approach was superior to SP approach regarding the ROM.

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Section: Resultscontrasting

confidence: 74%

supporting

confidence: 92%

Suprapatellar versus infrapatellar approaches in the treatment of tibia intramedullary nailing ： A retrospective cohort study

Cui

Hua

Schmidutz

et al. 2019

Preprint

View full text Add to dashboard Cite

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“…Daniel S. Chan et al conducted a prospective randomised pilot study to compare the clinical and functional outcomes of the knee joint after infrapatellar versus suprapatellar tibial nail insertion. [7] The results were that a total of 41 patients/fractures were enrolled in this study. Of those, only 25 patients/fractures (14 IP, 11 SP) fully complied with and completed 12 months of follow-up.…”

Section: Discussionmentioning

confidence: 95%

“…It also avoids elevated compartment pressures seen with prolonged traction. [6][7][8][9][10] Anterior knee pain is one of the most common complaints after tibial intramedullary nailing. This has a significant economic impact, since the majority of tibial fractures that require nailing are sustained by men with an average age of 31 years.…”

Section: Name and Address Of Corresponding Authormentioning

confidence: 99%

A Prospective Study Comparing the Outcome of Supra-Patellar and Infra-Patellar Tibial Nail Insertion

Samuel¹,

Prasad²,

Ranjan³

et al. 2017

AIMDR

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“…There is increasing interest in the literature in the use of the suprapatellar approach rather than the traditional infrapatellar approach as this may reduce this complication. Although to our knowledge, no randomised controlled trial has been published, other studies comparing these approaches have used subjective patient-reported outcome measures (PROMs) rather than objective outcome measures [4,5].…”

Section: Introductionmentioning

confidence: 99%

The Aberdeen Weight-Bearing Test (Knee): a new objective test for anterior knee discomfort

Macdonald

Rehman

Carnegie

et al. 2018

Eur J Trauma Emerg Surg

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Purpose We present the Aberdeen Weight-Bearing Test (Knee), an objective test specific for anterior knee discomfort assessed via load bearing. We assess its validity by performing it on normal subjects with no knee symptoms and subjects who had undergone anterograde tibial nailing. Methods Two scales are placed parallel on the floor with the dials concealed from the subject. The subject then kneels with one knee on each scale. The weight through each knee is recorded at 0, 15, 30, 45, and 60 s. The proportion of total body weight on each leg at each timepoint is calculated, and a ratio calculated from the values. A value of 1 equates to equal weight on each leg. The test was performed on 53 normal subjects and 38 subjects who had undergone tibial nailing. Results In the normal group, no significant difference in mean ratio of weight distribution (left:right) was seen at any timepoint (mean ratio range = 0.98-0.99, p value range = 0.18-0.64). In the tibial nail group, a difference was observed in mean ratio of weight distribution (injured:uninjured) favouring the uninjured leg, reaching significance at 0, 15, 30, and 45 s (mean ratio range = 0.88-0.94, p value range = 0.01-0.02). At 60 s, the mean ratio was 0.93 (p = 0.09). Conclusion The Aberdeen Weight-Bearing Test (Knee) is an objective, easily reproducible, specific test for anterior knee discomfort. It produces different results in individuals who have undergone anterograde tibial nailing compared to individuals with no knee symptoms.

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Suprapatellar Versus Infrapatellar Tibial Nail Insertion

Abstract: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.

Cited by 116 publications

References 17 publications

Suprapatellar versus infrapatellar approaches in the treatment of tibia intramedullary nailing ： A retrospective cohort study

Suprapatellar versus infrapatellar approaches in the treatment of tibia intramedullary nailing ： A retrospective cohort study

A Prospective Study Comparing the Outcome of Supra-Patellar and Infra-Patellar Tibial Nail Insertion

The Aberdeen Weight-Bearing Test (Knee): a new objective test for anterior knee discomfort

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