Tibial intramedullary nailing using a suprapatellar approach for the treatment of proximal tibial fractures / 中国骨伤

ABSTRACT

<p><b>OBJECTIVE</b>To study the clinical efficacy of semiextended intramedullary nailing of the tibia using a suprapatellar approach for proximal tibial fractures.</p><p><b>METHODS</b>From January 2013 to January 2014, a total of 16 patients with unilateral proximal tibial fractures, 14 males and 2 females, underwent closed reduction and internal fixation with TRIGEN™ META-NAIL™ via the suprapatellar approach. The average age was 42.2 years old (ranged, 26 to 57 years old). Radiographic and clinical follow-up examinations were performed at a minimum of 1 year after surgery. Measurements included surgery time, complications, bone healing time, tibial alignment, knee range of motion, pain scoring (visual analogue scale) and functional outcome (Lysholm knee score).</p><p><b>RESULTS</b>The average surgery time was (75.7±8.3) minutes (ranged, 65 to 95 minutes). No obvious complications were recorded. Average duration of follow-up was (15.6±8.1) months (ranged, 12 to 24 months). Fifteen patients attained radiological bone union for a mean time of (3.6±1.8) months (ranged, 3 to 5 months). At the final follow-up, all tibial alignments were good, and no patients complained of anterior knee pain. Mean arc of knee motion was (124.4±18.8) degrees for the affected extremity compared with (127.5±16.7) degrees for the contra-lateral knee. The total scores of Lysholm knee score ranged from 77 to 92, average 86.4±12.3.</p><p><b>CONCLUSION</b>For proximal tibial fractures,the semiextended intramedullary nailing technique via a suprapatellar approach can obtain satisfactory clinical outcomes with simplicity in reduction and fixation, minimal complications, and good recovery of limbs function.</p>