Surgical approaches to intramedullary nailing of the tibia: Comparative analysis of knee pain and functional outcomes

Injury
Wajeeh R BakhshMichael J Gardner

Abstract

Post-operative knee pain is common following intramedullary nailing of the tibia, regardless of surgical approach, though the exact source is controversial. Historically, the most common surgical approaches position the knee in hyperflexion, including patellar tendon splitting (PTS) and medial parapatellar (MPP). A novel technique, the semi-extended lateral parapatellar approach simplifies patient positioning, fracture reduction, fluoroscopic assessment, and implant insertion. It also avoids violation of the knee joint capsule. However, this approach has not yet been directly compared against the historical standards. We hypothesised that in a comparison of patient outcomes, the semi-extended approach would be associated with decreased knee pain and better function relative to knee hyperflexion approaches. A trauma patient database from a Level I centre was queried for patients who underwent intramedullary nailing of the tibia between 2009 and 2013. Patients were surveyed for knee pain severity (NRS scale 1 to 10) and location, and completion of the Lysholm Knee Scale (LKS). Data was compared between the semi-extended lateral parapatellar, medial parapatellar, and tendon splitting groups regarding knee pain severity, location, ...Continue Reading

References

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Citations

Aug 11, 2018·The Journal of the American Academy of Orthopaedic Surgeons·Julius A BishopMichael J Gardner
Nov 22, 2018·Current Opinion in Pediatrics·Aristides I CruzPeter D Fabricant
Feb 23, 2019·JBJS Reviews·Jeremy E RaduchaPeter D Fabricant
Dec 21, 2018·Journal of Orthopaedic Trauma·Ishaq IbrahimEdward K Rodriguez
Mar 5, 2020·AORN Journal
Apr 14, 2020·Clinical Orthopaedics and Related Research·Lisa K CannadaStephen A Kottmeier
Jul 9, 2020·Journal of Orthopaedic Trauma·Nathaniel E SchafferMark E Hake
Mar 1, 2019·JBJS Reviews·Jeremy E RaduchaPeter D Fabricant
Mar 30, 2020·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Sehan ParkJi Wan Kim
Aug 11, 2020·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Mandala S LeliveldEsther M M Van Lieshout
Mar 9, 2019·Archives of Orthopaedic and Trauma Surgery·Andreas LadurnerChristoph Sommer
Jul 10, 2018·Journal of Orthopaedic Trauma·Christopher M McAndrewMatthew C Avery
Jul 9, 2020·Journal of Orthopaedic Trauma·David J CinatsTrevor Stone
Oct 17, 2020·Journal of Orthopaedic Trauma·David J CinatsTrevor Stone

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