Skip to main content
Erschienen in: International Orthopaedics 12/2016

07.05.2016 | Original Paper

The outcome comparison of the suprapatellar approach and infrapatellar approach for tibia intramedullary nailing

Erschienen in: International Orthopaedics | Ausgabe 12/2016

Einloggen, um Zugang zu erhalten

Abstract

Objectives

This paper aimed to compare the outcome of suprapatellar and infrapatellar approaches for the tibia intramedullary nailing.

Methods

From February 2010 to August 2013, a total of 162 skeletally mature participants with tibia shaft fractures were identified and divided into suprapatellar approach group (SPAG) and infrapatellar approach group (IPAG) randomly. Fluoroscopy time, length of hospital stay, operative time, blood loss and complications were recorded. Visual analog score (VAS), Lysholm knee score and range of motion (ROM) were reviewed at one, three, six, 12 and 24 months post-operatively. All patients were required to complete short form 36 questionnaire (SF-36) at six, 12 and 24 months postoperatively.

Results

The follow–ups lasted two years at least. No significant differences were in major complication rate, operation time, blood loss, the ROM of injured extremity and length of hospital stay between SPAG and IPAG. Nevertheless, the fluoroscopy time was significantly lower in SPAG. VAS pain scores were lower in SPAG at six, 12 and 24 months post-operatively. A higher Lysholm knee score was observed in SPAG at six and 24 months post-operatively. Besides, a better overall physical components score was observed in SPAG except at six months post-operatively.

Conclusions

The suprapatellar approach was superior to infrapatrellar approach for the treatment of tibia shaft fracture. Therefore, we recommend the suprapatellar approach as a preferable approach in tibia intramedullary nailing.
Literatur
1.
Zurück zum Zitat Larsen P, Lund H, Laessoe U, Graven-Nielsen T, Rasmussen S (2014) Restrictions in quality of life after intramedullary nailing of tibial shaft fracture: a retrospective follow-up study of 223 cases. J Orthop Trauma 28(9):507–512. doi:10.1097/bot.0000000000000031 CrossRefPubMed Larsen P, Lund H, Laessoe U, Graven-Nielsen T, Rasmussen S (2014) Restrictions in quality of life after intramedullary nailing of tibial shaft fracture: a retrospective follow-up study of 223 cases. J Orthop Trauma 28(9):507–512. doi:10.​1097/​bot.​0000000000000031​ CrossRefPubMed
2.
Zurück zum Zitat Weiss RJ, Montgomery SM, Ehlin A, Al Dabbagh Z, Stark A, Jansson KA (2008) Decreasing incidence of tibial shaft fractures between 1998 and 2004: information based on 10,627 Swedish inpatients. Acta Orthop 79(4):526–533. doi:10.1080/17453670710015535 CrossRefPubMed Weiss RJ, Montgomery SM, Ehlin A, Al Dabbagh Z, Stark A, Jansson KA (2008) Decreasing incidence of tibial shaft fractures between 1998 and 2004: information based on 10,627 Swedish inpatients. Acta Orthop 79(4):526–533. doi:10.​1080/​1745367071001553​5 CrossRefPubMed
4.
Zurück zum Zitat Rodrigues FL, de Abreu LC, Valenti VE, Valente AL, da Costa Pereira Cestari R, Pohl PH, Rodrigues LM (2014) Bone tissue repair in patients with open diaphyseal tibial fracture treated with biplanar external fixation or reamed locked intramedullary nailing. Injury 45(Suppl 5):S32–S35. doi:10.1016/s0020-1383(14)70018-x CrossRefPubMed Rodrigues FL, de Abreu LC, Valenti VE, Valente AL, da Costa Pereira Cestari R, Pohl PH, Rodrigues LM (2014) Bone tissue repair in patients with open diaphyseal tibial fracture treated with biplanar external fixation or reamed locked intramedullary nailing. Injury 45(Suppl 5):S32–S35. doi:10.​1016/​s0020-1383(14)70018-x CrossRefPubMed
5.
Zurück zum Zitat Inan M, Halici M, Ayan I, Tuncel M, Karaoglu S (2007) Treatment of type IIIA open fractures of tibial shaft with Ilizarov external fixator versus unreamed tibial nailing. Arch Orthop Trauma Surg 127(8):617–623. doi:10.1007/s00402-007-0332-9 CrossRefPubMed Inan M, Halici M, Ayan I, Tuncel M, Karaoglu S (2007) Treatment of type IIIA open fractures of tibial shaft with Ilizarov external fixator versus unreamed tibial nailing. Arch Orthop Trauma Surg 127(8):617–623. doi:10.​1007/​s00402-007-0332-9 CrossRefPubMed
6.
Zurück zum Zitat Kaftandziev I, Pejkova S, Saveski J (2006) Operative treatment of III grade open fractures of the tibial diaphysis. Prilozi / Makedonska akademija na naukite i umetnostite, Oddelenie za bioloski i medicinski nauki = contributions / Macedonian academy of sciences and arts. Section Biol Med Sci 27(1):121–131 Kaftandziev I, Pejkova S, Saveski J (2006) Operative treatment of III grade open fractures of the tibial diaphysis. Prilozi / Makedonska akademija na naukite i umetnostite, Oddelenie za bioloski i medicinski nauki = contributions / Macedonian academy of sciences and arts. Section Biol Med Sci 27(1):121–131
7.
Zurück zum Zitat Bhandari M, Zlowodzki M, Tornetta P 3rd, Schmidt A, Templeman DC (2005) Intramedullary nailing following external fixation in femoral and tibial shaft fractures. J Orthop Trauma 19(2):140–144CrossRefPubMed Bhandari M, Zlowodzki M, Tornetta P 3rd, Schmidt A, Templeman DC (2005) Intramedullary nailing following external fixation in femoral and tibial shaft fractures. J Orthop Trauma 19(2):140–144CrossRefPubMed
8.
Zurück zum Zitat Jones M, Parry M, Whitehouse M, Mitchell S (2014) Radiologic outcome and patient-reported function after intramedullary nailing: a comparison of the retropatellar and infrapatellar approach. J Orthop Trauma 28(5):256–262. doi:10.1097/bot.0000000000000070 CrossRefPubMed Jones M, Parry M, Whitehouse M, Mitchell S (2014) Radiologic outcome and patient-reported function after intramedullary nailing: a comparison of the retropatellar and infrapatellar approach. J Orthop Trauma 28(5):256–262. doi:10.​1097/​bot.​0000000000000070​ CrossRefPubMed
10.
Zurück zum Zitat Toivanen JA, Vaisto O, Kannus P, Latvala K, Honkonen SE, Jarvinen MJ (2002) Anterior knee pain after intramedullary nailing of fractures of the tibial shaft. A prospective, randomized study comparing two different nail-insertion techniques. J Bone Joint Surg Am 84-a(4):580–585CrossRefPubMed Toivanen JA, Vaisto O, Kannus P, Latvala K, Honkonen SE, Jarvinen MJ (2002) Anterior knee pain after intramedullary nailing of fractures of the tibial shaft. A prospective, randomized study comparing two different nail-insertion techniques. J Bone Joint Surg Am 84-a(4):580–585CrossRefPubMed
11.
Zurück zum Zitat Hernigou P, Cohen D (2000) Proximal entry for intramedullary nailing of the tibia. The risk of unrecognised articular damage. J Bone Joint Surg Br 82(1):33–41CrossRefPubMed Hernigou P, Cohen D (2000) Proximal entry for intramedullary nailing of the tibia. The risk of unrecognised articular damage. J Bone Joint Surg Br 82(1):33–41CrossRefPubMed
13.
Zurück zum Zitat Sanders RW, DiPasquale TG, Jordan CJ, Arrington JA, Sagi HC (2014) Semiextended intramedullary nailing of the tibia using a suprapatellar approach: radiographic results and clinical outcomes at a minimum of 12 months follow-up. J Orthop Trauma 28(Suppl 8):S29–S39. doi:10.1097/01.bot.0000452787.80923.ee CrossRefPubMed Sanders RW, DiPasquale TG, Jordan CJ, Arrington JA, Sagi HC (2014) Semiextended intramedullary nailing of the tibia using a suprapatellar approach: radiographic results and clinical outcomes at a minimum of 12 months follow-up. J Orthop Trauma 28(Suppl 8):S29–S39. doi:10.​1097/​01.​bot.​0000452787.​80923.​ee CrossRefPubMed
14.
Zurück zum Zitat Bhandari M, Guyatt G, Tornetta P 3rd, Schemitsch E, Swiontkowski M, Sanders D, Walter SD (2008) Study to prospectively evaluate reamed intramedually nails in patients with tibial fractures (S.P.R.I.N.T.): study rationale and design. BMC Musculoskelet Disord 9:91. doi:10.1186/1471-2474-9-91 CrossRefPubMed Bhandari M, Guyatt G, Tornetta P 3rd, Schemitsch E, Swiontkowski M, Sanders D, Walter SD (2008) Study to prospectively evaluate reamed intramedually nails in patients with tibial fractures (S.P.R.I.N.T.): study rationale and design. BMC Musculoskelet Disord 9:91. doi:10.​1186/​1471-2474-9-91 CrossRefPubMed
16.
Zurück zum Zitat Chan DS, Serrano R, Griffing R, Steverson B, Infante A, Watson D, Sagi HC, Sanders RW (2015) Supra- versus Infra-patellar tibial nail insertion: a prospective, randomized control pilot study. J Orthop Trauma. doi:10.1097/bot.0000000000000499 Chan DS, Serrano R, Griffing R, Steverson B, Infante A, Watson D, Sagi HC, Sanders RW (2015) Supra- versus Infra-patellar tibial nail insertion: a prospective, randomized control pilot study. J Orthop Trauma. doi:10.​1097/​bot.​0000000000000499​
18.
Zurück zum Zitat Straub RK, Cipriani DJ (2012) Influence of infrapatellar and suprapatellar straps on quadriceps muscle activity and onset timing during the body-weight squat. J Strength Conditioning Res Nat Strength Conditioning Assoc 26(7):1827–1837. doi:10.1519/JSC.0b013e318234e81d CrossRef Straub RK, Cipriani DJ (2012) Influence of infrapatellar and suprapatellar straps on quadriceps muscle activity and onset timing during the body-weight squat. J Strength Conditioning Res Nat Strength Conditioning Assoc 26(7):1827–1837. doi:10.​1519/​JSC.​0b013e318234e81d​ CrossRef
19.
Zurück zum Zitat Gelbke MK, Coombs D, Powell S, DiPasquale TG (2010) Suprapatellar versus infra-patellar intramedullary nail insertion of the tibia: a cadaveric model for comparison of patellofemoral contact pressures and forces. J Orthop Trauma 24(11):665–671. doi:10.1097/BOT.0b013e3181f6c001 CrossRefPubMed Gelbke MK, Coombs D, Powell S, DiPasquale TG (2010) Suprapatellar versus infra-patellar intramedullary nail insertion of the tibia: a cadaveric model for comparison of patellofemoral contact pressures and forces. J Orthop Trauma 24(11):665–671. doi:10.​1097/​BOT.​0b013e3181f6c001​ CrossRefPubMed
20.
Zurück zum Zitat Sanders RW, Dipasquale TG, Jordan CJ, Arrington JA, Sagi HC (2014) Semiextended intramedullary nailing of the tibia using a suprapatellar approach: radiographic results and clinical outcomes at a minimum of 12 months follow-up. J Orthop Trauma 28(5):245–255CrossRefPubMed Sanders RW, Dipasquale TG, Jordan CJ, Arrington JA, Sagi HC (2014) Semiextended intramedullary nailing of the tibia using a suprapatellar approach: radiographic results and clinical outcomes at a minimum of 12 months follow-up. J Orthop Trauma 28(5):245–255CrossRefPubMed
21.
Zurück zum Zitat Courtney PM, Boniello A, Donegan D, Ahn J, Mehta S (2015) Functional knee outcomes in infrapatellar and suprapatellar tibial nailing: does approach matter? Am J Orthop (Belle Mead, NJ) 44(12):E513–E516 Courtney PM, Boniello A, Donegan D, Ahn J, Mehta S (2015) Functional knee outcomes in infrapatellar and suprapatellar tibial nailing: does approach matter? Am J Orthop (Belle Mead, NJ) 44(12):E513–E516
23.
Zurück zum Zitat Aksahin E, Yilmaz S, Karasoy I, Duran S, Yuksel HY, Dogan O, Yildirim AO, Bicimoglu A (2015) Sagittal patellar tilt and concomitant quadriceps hypotrophy after tibial nailing. Knee Surg Sports Traumatol Arthroscopy Off J ESSKA. doi:10.1007/s00167-015-3533-8 Aksahin E, Yilmaz S, Karasoy I, Duran S, Yuksel HY, Dogan O, Yildirim AO, Bicimoglu A (2015) Sagittal patellar tilt and concomitant quadriceps hypotrophy after tibial nailing. Knee Surg Sports Traumatol Arthroscopy Off J ESSKA. doi:10.​1007/​s00167-015-3533-8
24.
Zurück zum Zitat Rothberg DL, Holt DC, Horwitz DS, Kubiak EN (2013) Tibial nailing with the knee semi-extended: review of techniques and indications: AAOS exhibit selection. J Bone Joint Surg Am 95(16):e116. doi:10.2106/jbjs.l.01223, 111-118CrossRefPubMed Rothberg DL, Holt DC, Horwitz DS, Kubiak EN (2013) Tibial nailing with the knee semi-extended: review of techniques and indications: AAOS exhibit selection. J Bone Joint Surg Am 95(16):e116. doi:10.​2106/​jbjs.​l.​01223, 111-118CrossRefPubMed
25.
Metadaten
Titel
The outcome comparison of the suprapatellar approach and infrapatellar approach for tibia intramedullary nailing
Publikationsdatum
07.05.2016
Erschienen in
International Orthopaedics / Ausgabe 12/2016
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-016-3187-2

Weitere Artikel der Ausgabe 12/2016

International Orthopaedics 12/2016 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

07.05.2024 Klinik aktuell Nachrichten

Extreme Arbeitsverdichtung und kaum Supervision: Dr. Andrea Martini, Sprecherin des Bündnisses Junge Ärztinnen und Ärzte (BJÄ) über den Frust des ärztlichen Nachwuchses und die Vorteile des Rucksack-Modells.

Aquatherapie bei Fibromyalgie wirksamer als Trockenübungen

03.05.2024 Fibromyalgiesyndrom Nachrichten

Bewegungs-, Dehnungs- und Entspannungsübungen im Wasser lindern die Beschwerden von Patientinnen mit Fibromyalgie besser als das Üben auf trockenem Land. Das geht aus einer spanisch-brasilianischen Vergleichsstudie hervor.

Endlich: Zi zeigt, mit welchen PVS Praxen zufrieden sind

IT für Ärzte Nachrichten

Darauf haben viele Praxen gewartet: Das Zi hat eine Liste von Praxisverwaltungssystemen veröffentlicht, die von Nutzern positiv bewertet werden. Eine gute Grundlage für wechselwillige Ärztinnen und Psychotherapeuten.

Proximale Humerusfraktur: Auch 100-Jährige operieren?

01.05.2024 DCK 2024 Kongressbericht

Mit dem demographischen Wandel versorgt auch die Chirurgie immer mehr betagte Menschen. Von Entwicklungen wie Fast-Track können auch ältere Menschen profitieren und bei proximaler Humerusfraktur können selbst manche 100-Jährige noch sicher operiert werden.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.