Lionel Llano1, Maria Liliana Soruco2, Danilo Taype Zamboni2, Carlos Sancineto2, Jorge Barla2, Guido Carabelli2. 1. Trauma Section, Instituto de Ortopedia y Traumatología "Carlos E. Ottolenghi" Hospital Italiano de, Tte. Gral. Juan D. Perón, 4190 C1199ABB, Buenos Aires, Argentina. lionel.llano@hospitalitaliano.org.ar. 2. Trauma Section, Instituto de Ortopedia y Traumatología "Carlos E. Ottolenghi" Hospital Italiano de, Tte. Gral. Juan D. Perón, 4190 C1199ABB, Buenos Aires, Argentina.
Abstract
INTRODUCTION: Intramedullary nailing is the most frequent procedure used for the treatment of tibial fractures that do not involve the articular surfaces. The goal of this study is to analyse the clinical outcomes, time of surgery and use of fluoroscopy in patients with midshaft and distal tibial fractures treated with suprapatellar and infrapatellar nailing and compare the results between these different groups. METHODS: A retrospective study was conducted, and patients were selected between the period of March 2018 and October 2019. The following variables were studied: age, gender, AO classification, time of surgery (minutes), time of fluoroscopy (seconds), quality of reduction in postoperative controls and 1 year follow-up (using the angles MPTA, LDTA, PPTA, ADTA). Functional outcomes were studied at 1 month and 1 year follow-up. The visual analogue scale was used to study and compare the postoperative pain of the patients. The Lysholm Knee Score was used to evaluate the functional outcomes of the patients. RESULTS: A total of 80 patients meeting the inclusion criteria were included in this study. The suprapatellar approach was used in 44 patients and the infrapatellar in 36 patients. The time of surgery (p=0.008) and the mean time of use of fluoroscopy (p <0.001) difference were significant in favour of the suprapatellar approach. In the quality of reduction analysis, we have statistically significant results in the LDTA and ADTA angles. Also, in the evaluation of postoperative pain, significant difference was found in favour of the suprapatellar approach. CONCLUSION: In conclusion, our study compared the suprapatellar approach and the infrapatellar approach for the treatment of midshaft and distal tibia fractures with intramedullary nailing. The results showed lesser time of surgery and use of fluoroscopy, lower knee pain, and lower rate of malalignment with the suprapatellar approach than with the infrapatellar approach.
INTRODUCTION: Intramedullary nailing is the most frequent procedure used for the treatment of tibial fractures that do not involve the articular surfaces. The goal of this study is to analyse the clinical outcomes, time of surgery and use of fluoroscopy in patients with midshaft and distal tibial fractures treated with suprapatellar and infrapatellar nailing and compare the results between these different groups. METHODS: A retrospective study was conducted, and patients were selected between the period of March 2018 and October 2019. The following variables were studied: age, gender, AO classification, time of surgery (minutes), time of fluoroscopy (seconds), quality of reduction in postoperative controls and 1 year follow-up (using the angles MPTA, LDTA, PPTA, ADTA). Functional outcomes were studied at 1 month and 1 year follow-up. The visual analogue scale was used to study and compare the postoperative pain of the patients. The Lysholm Knee Score was used to evaluate the functional outcomes of the patients. RESULTS: A total of 80 patients meeting the inclusion criteria were included in this study. The suprapatellar approach was used in 44 patients and the infrapatellar in 36 patients. The time of surgery (p=0.008) and the mean time of use of fluoroscopy (p <0.001) difference were significant in favour of the suprapatellar approach. In the quality of reduction analysis, we have statistically significant results in the LDTA and ADTA angles. Also, in the evaluation of postoperative pain, significant difference was found in favour of the suprapatellar approach. CONCLUSION: In conclusion, our study compared the suprapatellar approach and the infrapatellar approach for the treatment of midshaft and distal tibia fractures with intramedullary nailing. The results showed lesser time of surgery and use of fluoroscopy, lower knee pain, and lower rate of malalignment with the suprapatellar approach than with the infrapatellar approach.
Authors: D R W MacDonald; P Caba-Doussoux; C A Carnegie; I Escriba; D P Forward; M Graf; A J Johnstone Journal: Bone Joint J Date: 2019-09 Impact factor: 5.082
Authors: Yao Lu; Gen Wang; Bin Hu; Cheng Ren; Liang Sun; Zhimeng Wang; Changjun He; Hanzhong Xue; Zhong Li; Kun Zhang; Teng Ma; Qian Wang Journal: J Orthop Surg Res Date: 2020-09-17 Impact factor: 2.359
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