Evaluation of the effectiveness of suprapatellar versus infrapatellar approach in intramedullary nailing for the treatment of tibial fractures
Abstract Background Intramedullary nailing (IMN) is the standard treatment for tibial shaft fractures, but the choice between the suprapatellar and infrapatellar approaches remains debated. This study aims to compare the effectiveness, functional outcomes, and safety of both approaches. Material and...
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BMC
2025-07-01
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| Series: | European Journal of Medical Research |
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| Online Access: | https://doi.org/10.1186/s40001-025-02865-0 |
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| author | Dan-Hai Wu Yong Zhang Ding Xu Wei-Gang Lou Jia-Yu Zhang |
| author_facet | Dan-Hai Wu Yong Zhang Ding Xu Wei-Gang Lou Jia-Yu Zhang |
| author_sort | Dan-Hai Wu |
| collection | DOAJ |
| description | Abstract Background Intramedullary nailing (IMN) is the standard treatment for tibial shaft fractures, but the choice between the suprapatellar and infrapatellar approaches remains debated. This study aims to compare the effectiveness, functional outcomes, and safety of both approaches. Material and methods This retrospective study included 126 adult patients with tibial shaft fractures treated with IMN between January 2020 and December 2022. Patients were divided into suprapatellar (n = 66) and infrapatellar (n = 60) groups. Outcomes assessed included operative time, fluoroscopy exposure, hospital stay, fracture healing time, knee function (Lysholm score), time to removal of internal fixation, complication rates, and clinical effectiveness (excellent-good rate). Results The suprapatellar group showed significantly shorter operative time (75.86 ± 9.80 min vs. 84.17 ± 10.47 min, p < 0.001), fewer fluoroscopy exposures (18.01 ± 4.89 vs. 32.13 ± 5.77, p < 0.001), and shorter hospital stay (6.73 ± 1.10 days vs. 8.05 ± 0.85 days, p < 0.001). Lysholm scores were significantly higher in the suprapatellar group (91.09 ± 6.42 vs. 82.04 ± 7.28, p < 0.001), indicating better knee function. Complication rates, including anterior knee pain, were lower in the suprapatellar group (15.15 vs. 33.33%, p = 0.017). The excellent-good rates were comparable between groups (84.85 vs. 83.33%, p = 0.816). Conclusions The suprapatellar approach could offer benefits over the infrapatellar approach, including reduced operative time, fluoroscopy exposure, and hospital stay, as well as improved knee function and fewer complications. It might be a preferable option for tibial fracture fixation. |
| format | Article |
| id | doaj-art-5afb6eee8c0b4b369286cf718adc486b |
| institution | DOAJ |
| issn | 2047-783X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | European Journal of Medical Research |
| spelling | doaj-art-5afb6eee8c0b4b369286cf718adc486b2025-08-20T03:04:31ZengBMCEuropean Journal of Medical Research2047-783X2025-07-013011910.1186/s40001-025-02865-0Evaluation of the effectiveness of suprapatellar versus infrapatellar approach in intramedullary nailing for the treatment of tibial fracturesDan-Hai Wu0Yong Zhang1Ding Xu2Wei-Gang Lou3Jia-Yu Zhang4Department of Trauma Orthopedics, Ningbo Sixth HospitalDepartment of Trauma Orthopedics, Ningbo Sixth HospitalDepartment of Trauma Orthopedics, Ningbo Sixth HospitalDepartment of Trauma Orthopedics, Ningbo Sixth HospitalDepartment of Trauma Orthopedics, Ningbo Sixth HospitalAbstract Background Intramedullary nailing (IMN) is the standard treatment for tibial shaft fractures, but the choice between the suprapatellar and infrapatellar approaches remains debated. This study aims to compare the effectiveness, functional outcomes, and safety of both approaches. Material and methods This retrospective study included 126 adult patients with tibial shaft fractures treated with IMN between January 2020 and December 2022. Patients were divided into suprapatellar (n = 66) and infrapatellar (n = 60) groups. Outcomes assessed included operative time, fluoroscopy exposure, hospital stay, fracture healing time, knee function (Lysholm score), time to removal of internal fixation, complication rates, and clinical effectiveness (excellent-good rate). Results The suprapatellar group showed significantly shorter operative time (75.86 ± 9.80 min vs. 84.17 ± 10.47 min, p < 0.001), fewer fluoroscopy exposures (18.01 ± 4.89 vs. 32.13 ± 5.77, p < 0.001), and shorter hospital stay (6.73 ± 1.10 days vs. 8.05 ± 0.85 days, p < 0.001). Lysholm scores were significantly higher in the suprapatellar group (91.09 ± 6.42 vs. 82.04 ± 7.28, p < 0.001), indicating better knee function. Complication rates, including anterior knee pain, were lower in the suprapatellar group (15.15 vs. 33.33%, p = 0.017). The excellent-good rates were comparable between groups (84.85 vs. 83.33%, p = 0.816). Conclusions The suprapatellar approach could offer benefits over the infrapatellar approach, including reduced operative time, fluoroscopy exposure, and hospital stay, as well as improved knee function and fewer complications. It might be a preferable option for tibial fracture fixation.https://doi.org/10.1186/s40001-025-02865-0Tibial fracturesIntramedullary nailingSuprapatellar approachInfrapatellar approachKnee function |
| spellingShingle | Dan-Hai Wu Yong Zhang Ding Xu Wei-Gang Lou Jia-Yu Zhang Evaluation of the effectiveness of suprapatellar versus infrapatellar approach in intramedullary nailing for the treatment of tibial fractures European Journal of Medical Research Tibial fractures Intramedullary nailing Suprapatellar approach Infrapatellar approach Knee function |
| title | Evaluation of the effectiveness of suprapatellar versus infrapatellar approach in intramedullary nailing for the treatment of tibial fractures |
| title_full | Evaluation of the effectiveness of suprapatellar versus infrapatellar approach in intramedullary nailing for the treatment of tibial fractures |
| title_fullStr | Evaluation of the effectiveness of suprapatellar versus infrapatellar approach in intramedullary nailing for the treatment of tibial fractures |
| title_full_unstemmed | Evaluation of the effectiveness of suprapatellar versus infrapatellar approach in intramedullary nailing for the treatment of tibial fractures |
| title_short | Evaluation of the effectiveness of suprapatellar versus infrapatellar approach in intramedullary nailing for the treatment of tibial fractures |
| title_sort | evaluation of the effectiveness of suprapatellar versus infrapatellar approach in intramedullary nailing for the treatment of tibial fractures |
| topic | Tibial fractures Intramedullary nailing Suprapatellar approach Infrapatellar approach Knee function |
| url | https://doi.org/10.1186/s40001-025-02865-0 |
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