Ishaq Ibrahim1, Andrew Johnson2, Edward K Rodriguez2. 1. Harvard Combined Orthopaedic Residency Program, Massachusetts General Hospital, Boston, MA. 2. Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Boston, MA.
Abstract
OBJECTIVE: To systematically review the existing literature to determine whether knee pain and function following intramedullary nailing of tibial shaft fractures differs significantly by surgical technique-specifically with semi-extended nailing versus traditional infrapatellar approaches. DATA SOURCE: A comprehensive search of PubMed/MEDLINE, EMBASE, and the Cochrane Database was conducted on August 15, 2018. STUDY SELECTION: We included level I-level III studies that examined outcomes of tibial intramedullary nailing utilizing a semi-extended technique. All included studies reported Lysholm Knee Scores with minimum clinical follow-up of 1 year. Non-English language literature and studies older than 20 years were not included. DATA EXTRACTION: Data from each study were independently recorded by 2 reviewers. DATA SYNTHESIS: Two prospective, randomized trials and 4 retrospective cohort studies were included in this review. A meta-analysis was not performed. CONCLUSIONS: Evidence comparing postoperative knee pain and functional outcomes between semi-extended and traditional infrapatellar nailing is limited. Available literature suggests satisfactory outcomes with semi-extended nailing. The highest level of evidence available does indicate improved pain and function with semi-extended nailing as compared to infrapatellar nailing. Additional research may be required to reach consensus conclusions. LEVEL OF EVIDENCE: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
OBJECTIVE: To systematically review the existing literature to determine whether knee pain and function following intramedullary nailing of tibial shaft fractures differs significantly by surgical technique-specifically with semi-extended nailing versus traditional infrapatellar approaches. DATA SOURCE: A comprehensive search of PubMed/MEDLINE, EMBASE, and the Cochrane Database was conducted on August 15, 2018. STUDY SELECTION: We included level I-level III studies that examined outcomes of tibial intramedullary nailing utilizing a semi-extended technique. All included studies reported Lysholm Knee Scores with minimum clinical follow-up of 1 year. Non-English language literature and studies older than 20 years were not included. DATA EXTRACTION: Data from each study were independently recorded by 2 reviewers. DATA SYNTHESIS: Two prospective, randomized trials and 4 retrospective cohort studies were included in this review. A meta-analysis was not performed. CONCLUSIONS: Evidence comparing postoperative knee pain and functional outcomes between semi-extended and traditional infrapatellar nailing is limited. Available literature suggests satisfactory outcomes with semi-extended nailing. The highest level of evidence available does indicate improved pain and function with semi-extended nailing as compared to infrapatellar nailing. Additional research may be required to reach consensus conclusions. LEVEL OF EVIDENCE: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Authors: Akshar H Patel; J Heath Wilder; Olivia C Lee; Austin J Ross; Krishna C Vemulapalli; Paul B Gladden; Murphy P Martin; William F Sherman Journal: Orthop Rev (Pavia) Date: 2022-01-30
Authors: Nils Jan Bleeker; Inge H F Reininga; Bryan J M van de Wall; Laurent A M Hendrickx; Frank J P Beeres; Kaj Ten Duis; Job N Doornberg; Ruurd L Jaarsma; Gino M M J Kerkhoffs; Frank F A IJpma Journal: J Orthop Trauma Date: 2021-08-01 Impact factor: 2.512