Tibial Nailing with the Knee Semi-Extended

Rothberg, David L.; Holt, David C; Horwitz, Daniel S.; Kubiak, Erik N.

doi:10.2106/jbjs.l.01223

Cited by 23 publications

(4 citation statements)

References 21 publications

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“…As per the literature, it is difficult to manage proximal tibia fractures using the infrapatellar approach in all cases. Malalignment occurs due to the pull of the patellar and quadriceps tendons [6]. Plating is an alternative, that allows direct visualization of fracture, but there is a disadvantage of improper axial fixation and increased risk of infection [7].…”

Section: Discussionmentioning

confidence: 99%

Management of the Tibial Shaft Fractures With a Suprapatellar Approach

AM,

KB,

KUMAR

et al. 2024

Asian J Pharm Clin Res

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Objectives: Tibia fractures are the most common long bone fractures, among which diaphyseal fractures are more common. Tibial diaphyseal fractures have a significant risk of non-union and malunion among all long bone fractures. Among adults, IMILN is the treatment of choice for unstable and displaced fractures. The traditional surgical method is the infrapatellar approach, which has its own drawbacks. Here, we are studying the suprapatellar approach. Methods: The prospective study was conducted on 25 patients in the Department of Orthopedics, Government General Hospital, Kurnool for 1 year from November 2022 to November 2023. Patients were examined clinically and functional outcomes were noted. Results: The suprapatellar approach shows an average operative time was 40–80 min and blood loss was around 70–90 mL. The mean time of union was 15–16 weeks. Conclusion: For tibial diaphyseal fractures, the suprapatellar approach is a safe and effective alternative nail insertion.

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Section: Discussionmentioning

confidence: 99%

Management of the Tibial Shaft Fractures With a Suprapatellar Approach

AM,

KB,

KUMAR

et al. 2024

Asian J Pharm Clin Res

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“…Unlike the traditional knee-flexed technique, in this approach, the injured limb remains semi-extended throughout the entire procedure, offering substantial benefits to the surgeon. The improved positioning of the C-arm parallel to the floor is notably advantageous, as it simplifies the acquisition of clear and consistent images in both anteroposterior (AP) and lateral (lat) views without any interference between the C-arm and the surgical field or instruments [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

The Lateral Para-Patellar Approach for Intramedullary Tibia Nailing in Distal Tibia Extra-articular Fractures: A Prospective Cohort Study

Mishra,

Pani,

Das

et al. 2024

Cureus

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Background and objectives: The treatment of extra-articular distal tibia fractures is still a subject of debate and frequently necessitates surgical treatment, and intramedullary nailing (IMN) offers a minimally invasive approach with excellent results. Important factors in these procedures are positioning, operative duration, and radiation exposure. This study details the semi-extended lateral para-patellar approach for IMN of distal tibia extra-articular fractures and documents our findings regarding operative time, intra-operative radiation exposure, residual anterior knee pain, knee functional and radiological outcomes at six months follow-up. Methods: We reviewed the cases of 60 patients who underwent IMN for distal tibia extra-articular fractures from May 2022 to March 2024, employing an extra-articular lateral para-patellar approach in the semi-extended position. Patients were evaluated clinically and radio-graphically for a minimum follow-up period of six months. Data collected included duration of surgery, intraoperative radiation exposure, and knee functional score for all patients. Assessment of fracture healing, residual deformities, residual anterior knee pain, and range of motion of the treated knee compared to the contralateral knee was done at a six-month follow-up. Results: The average surgery duration was 54 ± 5 minutes, with intraoperative imaging averaging 48 exposures. The average time to union was 16 ± 3 weeks. Six months post-surgery, the mean Knee Society Score was 86.4 ± 3.5 (out of 100). At the six months follow-up, all patients exhibited clinical and radiographic healing, with only two cases showing mal-alignment (angular deformity <10 degrees). All patients regained a comparable range of motion in their knees. Conclusions: The semi-extended lateral para-patellar approach for nailing of distal tibia extra-articular fractures enhances reduction, simplifies nail insertion, reduces both fluoroscopy and operative time, minimizes anterior knee pain and improves knee functional outcomes at six months follow-up.

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“…Tibial shaft fractures are extremely common injuries [12]. The preferred management for most tibial shaft fractures is intramedullary nailing, which generally yields a high rate of union, low complication rates, and good functional outcomes [13].…”

Section: Discussionmentioning

confidence: 99%

Outcome of Medial Parapatellar Versus Transpatellar Tendon Approach of Intramedullary Nail Insertion Techniques in Tibial Shaft Fractures

Mohsen

2023

Int J Sci Healthcare Res

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Background: Fractures of the tibia are among the most serious long bone fractures. Materials and method: This is a retrospective study conducted in Aden. We reviewed records of patients who were admitted and treated for tibial fractures by intramedullary nail. We gathered data from 48 patients, underwent MPA and TPA approach for surgery. SPSS version 17 was used to analyze the data. The Fisher test was used to compare the two groups, MPA and TPA group. The significance level was set at P<0.05. Results: Males were (72.9%) and females were (27.1%). Their mean age was 37 ± 11.9 years. Stair ascending impairment were found in MPA approach (20.8%) and (29.2%) after TPA (p > 0.05). Limping was found in MPA group (22.9%) and (20.8%) in TPA group (p > 0.05). Inability squaring found in MPA group (27.1%) and (29.2%) in TPA group, (p > 0.05). Anterior knee pain was found in (27.1%) of MPA approach and (35.4%) in TPA approach, (p > 0.05). In the MPA insertion approach, (29.2%) patients showed a full flexion after two days of the surgical insertion while in TPA approach there were (16.6%) patients showed a full flexion (p > 0.05). Full extraction found in MPA approach (33.3%) after 2 days of surgery and (29.2%) in TPA approach, (p > 0.05). After 2 days (31.3%) patients whom treated with MPA approach and (22.9%) whom treated with TPA approach. Conclusion: The study showed us the advantage of medial parapatellar tendon approach of treating the tibial shaft fractures. Keywords: Outcome, intramedullary nail, tibia, fracture.

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Tibial Nailing with the Knee Semi-Extended

Cited by 23 publications

References 21 publications

Management of the Tibial Shaft Fractures With a Suprapatellar Approach

Management of the Tibial Shaft Fractures With a Suprapatellar Approach

The Lateral Para-Patellar Approach for Intramedullary Tibia Nailing in Distal Tibia Extra-articular Fractures: A Prospective Cohort Study

Outcome of Medial Parapatellar Versus Transpatellar Tendon Approach of Intramedullary Nail Insertion Techniques in Tibial Shaft Fractures

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