Key result
Suprapatellar and infrapatellar tibial nailing show equivalent knee scores, but infrapatellar yields superior range of motion.
Why the study?
The study compared clinical and functional knee joint outcomes after tibia intramedullary nailing using a suprapatellar versus traditional infrapatellar approach.
Does the suprapatellar approach improve knee functional outcomes compared to the infrapatellar approach in patients undergoing tibia intramedullary nailing?
Cohort (n=50)
Does the suprapatellar approach improve knee functional outcomes compared to the infrapatellar approach in patients undergoing tibia intramedullary nailing?
Answers are grounded in this paper and cite their sources.
Both suprapatellar and infrapatellar approaches for tibia intramedullary nailing result in equivalent overall knee functional scores, although the infrapatellar approach may yield slightly better range of motion.
Background: Tibial shaft fractures are routinely managed with intramedullary nailing (IMN). An increasingly accepted technique is the suprapatellar (SP) approach. The purpose of this study was to compare the clinical and functional outcomes of knee joint after tibia IMN through an suprapatellar (SP) or traditional infrapatellar (IP) approach. Methods: Retrospective analysis was performed in patients with tibial shaft fractures that were treated with IMN through a SP or IP approach between 01/01/2014 and 31/12/2016. The clinical and functional outcomes of the knee were assessed with the Hospital for Special Surgery (HSS) Knee Score. Secondary outcomes included the operation time and intraoperative blood loss. Results: A total of 50 patients/fractures (26 IP and 24 SP) with a minimum follow-up of 15 months were evaluated. All fractures were OTA 42. No significant differences were found between the two groups in age, gender, side of fractures, operation time, intra-operative blood loss, and follow-up time. No significant difference was seen in HSS score ( P = 0.62) between them. Sub analysis of all the HSS components scores revealed no significant differences between pain ( P = 0.57), the stand and walk ( P = 0.54), the need for walking stick ( P = 0.60) and extension lag ( P = 0.60). The other HSS components showed full scores (IP 10 vs. SP 10) in both approaches, including muscle force, flexion deformity and stability components. The range of motion (ROM) component score was superior in the IP group ( P = 0.04) suggesting a higher ROM. Conclusions: Both SP and IP approach results in equivalent overall HSS knee scores. However, for the HSS component, the IP approach was superior to SP approach regarding the ROM.
No takes yet. Share an insight, caveat, or question.
Cui et al. (2019) conducted a cohort in Tibial shaft fractures (n=50). Suprapatellar (SP) approach vs. Infrapatellar (IP) approach was evaluated on Hospital for Special Surgery (HSS) Knee Score (p=0.62). Suprapatellar and infrapatellar approaches for tibial intramedullary nailing resulted in equivalent overall HSS knee scores (P=0.62), though the infrapatellar approach had superior range of motion.
Synapse has enriched 8 closely related papers on similar clinical questions. Consider them for comparative context: