A Prospective Interventional Study to Assess Functional Outcomes of Suprapatellar vs Infrapatellar Approaches for Intramedullary Interlocking Nailing in Tibial Shaft Fractures
Introduction: Tibial shaft fractures are common orthopedic injuries treated with various modalities, including intramedullary nailing (IMN). Even though infrapatellar nailing (IPN) is commonly done, suprapatellar nailing (SPN) has gained popularity in recent times, with conflicting evidence on their...
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| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Jaypee Brothers Medical Publisher
2025-01-01
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| Series: | Journal of Orthopedics and Joint Surgery |
| Subjects: | |
| Online Access: | https://www.jojs.in/doi/JOJS/pdf/10.5005/jojs-10079-1195 |
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| Summary: | Introduction: Tibial shaft fractures are common orthopedic injuries treated with various modalities, including intramedullary nailing (IMN). Even though infrapatellar nailing (IPN) is commonly done, suprapatellar nailing (SPN) has gained popularity in recent times, with conflicting evidence on their comparative efficacy.
Aims and objectives: This prospective interventional study compared the functional outcomes of tibial fractures treated with suprapatellar (SP) vs infrapatellar (IP) intramedullary interlocking nailing (IMIL). The objectives were to assess clinical, radiological, and surgical outcomes and identify complications associated with each approach.
Materials and methods: The study includes a total of 80 patients with tibial diaphyseal fractures, divided into group A (SP approach) and group B (IP approach). Clinical outcomes were assessed using the visual analog scale (VAS), Lysholm knee scoring scale (LKSS), and lower extremity functional scale (LEFS). Radiological outcomes were evaluated using the Radiographic Union Scale in Tibial Fractures (RUST score), translational alignment, and angulation. Surgical parameters and complications were recorded, and statistical analysis was performed to compare group outcomes.
Results: Group A demonstrated superior functional outcomes based on VAS scores, LKSS, and LEFS at all follow-up intervals (<italic>p</italic> < 0.05). Radiological outcomes favored group A, with higher RUST scores and better translational alignment (<italic>p</italic> < 0.05). Both groups showed similar angles and time to union.
Conclusion: The SP approach (group A) for tibial shaft fractures exhibited better surgical and functional outcomes compared to the IP approach (group B). SP group patients had lower pain scores, better functional outcomes, and superior radiological healing. The findings indicate that the SP approach may be the preferred method for managing tibial shaft fractures, particularly in the proximal third and distal third shaft fractures, as evidenced by improved patient outcomes compared to the IP group. Nevertheless, additional research involving larger sample sizes and extended follow-up periods is needed to substantiate these findings thoroughly.
Clinical significance: For all tibial shaft fractures, the SPN approach proves to have a shorter surgical time and lesser radiation exposure with better functional outcomes. Hence, the SPN approach can be adopted for all tibial diaphyseal fractures. |
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| ISSN: | 2582-7863 |