Intramedullary Nail Fixation by Suprapatellar and Infrapatellar Approaches for Treatment of Distal Tibial Fractures
Objective To compare the functional and alignment outcomes of intramedullary nail fixation using suprapatellar and infrapatellar approaches in treating distal tibial fractures. Methods In this retrospective study, 132 patients with distal tibial fractures (87 men, 45 women) ranging in age from 20 to...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-09-01
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| Series: | Orthopaedic Surgery |
| Online Access: | https://doi.org/10.1111/os.13397 |
| _version_ | 1811183753264889856 |
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| author | Feng Gao Xiu‐Hui Wang Sheng‐Li Xia Xiao‐Xiao Zhou Ming‐Hui Wang Bei‐Gang Fu Cun‐Guo Yi Sheng‐Yang Guo |
| author_facet | Feng Gao Xiu‐Hui Wang Sheng‐Li Xia Xiao‐Xiao Zhou Ming‐Hui Wang Bei‐Gang Fu Cun‐Guo Yi Sheng‐Yang Guo |
| author_sort | Feng Gao |
| collection | DOAJ |
| description | Objective To compare the functional and alignment outcomes of intramedullary nail fixation using suprapatellar and infrapatellar approaches in treating distal tibial fractures. Methods In this retrospective study, 132 patients with distal tibial fractures (87 men, 45 women) ranging in age from 20 to 66 years were treated with intramedullary nails using the suprapatellar (69 patients) or infrapatellar (63 patients) approach. The radiographic alignment outcomes and ankle function were compared between the two groups. Multivariate logistic regression analyses were performed to determine which variety influenced ankle functional scores and whether the suprapatellar approach intervention demonstrated a protective effect. Results The mean follow‐up time was 14.22 ± 2.31 months. The mean sagittal section angle of the fracture in the suprapatellar and infrapatellar approach groups was 3.20° ± 1.20° and 5.31° ± 1.23°, respectively (P < 0.001). The mean coronal section angle was 3.51° ± 0.89° and 5.42° ± 1.05°, respectively (P < 0.001). Three patients (4.3%) in the suprapatellar approach group and 15 patients (23.8%) in the infrapatellar approach group had poor fracture reduction (P < 0.001). The mean hind foot functional score and ankle pain score were 95.91 ± 4.70 and 35.91 ± 4.70 points, respectively, in the suprapatellar approach group and 85.20 ± 5.61 and 25.20 ± 5.61 points, respectively, in the infrapatellar approach group (P < 0.001 for both). In the comparison of ankle function, the multivariate logistic regression analyses demonstrated that the odds ratio in the suprapatellar approach group was about 7 times that in the infrapatellar approach group (odds ratio, 7.574; 95% confidence interval, 2.148–28.740; P = 0.002). Of the variants measured, the statistically significant risk factors for poor ankle function were AO type A3 (P = 0.016) and diabetes mellitus (P = 0.006). Sex and the operation interval were not statistically significant risk factors for poor ankle function. Conclusion Intramedullary nailing using the suprapatellar approach facilitates simple fracture reduction, excellent postoperative fracture alignment, and few complications, giving it obvious advantages over the conventional infrapatellar approach. Additionally, the suprapatellar approach is a prognostic factor associated with postoperative ankle joint function. |
| first_indexed | 2024-04-11T09:52:20Z |
| format | Article |
| id | doaj.art-d625a34900a1439698657145511e0151 |
| institution | Directory Open Access Journal |
| issn | 1757-7853 1757-7861 |
| language | English |
| last_indexed | 2024-04-11T09:52:20Z |
| publishDate | 2022-09-01 |
| publisher | Wiley |
| record_format | Article |
| series | Orthopaedic Surgery |
| spelling | doaj.art-d625a34900a1439698657145511e01512022-12-22T04:30:45ZengWileyOrthopaedic Surgery1757-78531757-78612022-09-011492350236010.1111/os.13397Intramedullary Nail Fixation by Suprapatellar and Infrapatellar Approaches for Treatment of Distal Tibial FracturesFeng Gao0Xiu‐Hui Wang1Sheng‐Li Xia2Xiao‐Xiao Zhou3Ming‐Hui Wang4Bei‐Gang Fu5Cun‐Guo Yi6Sheng‐Yang Guo7Shanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, Shanghai Pudong New District Zhoupu Hospital Shanghai ChinaShanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, Shanghai Pudong New District Zhoupu Hospital Shanghai ChinaShanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, Shanghai Pudong New District Zhoupu Hospital Shanghai ChinaShanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, Shanghai Pudong New District Zhoupu Hospital Shanghai ChinaShanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, Shanghai Pudong New District Zhoupu Hospital Shanghai ChinaShanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, Shanghai Pudong New District Zhoupu Hospital Shanghai ChinaShanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, Shanghai Pudong New District Zhoupu Hospital Shanghai ChinaShanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, Shanghai Pudong New District Zhoupu Hospital Shanghai ChinaObjective To compare the functional and alignment outcomes of intramedullary nail fixation using suprapatellar and infrapatellar approaches in treating distal tibial fractures. Methods In this retrospective study, 132 patients with distal tibial fractures (87 men, 45 women) ranging in age from 20 to 66 years were treated with intramedullary nails using the suprapatellar (69 patients) or infrapatellar (63 patients) approach. The radiographic alignment outcomes and ankle function were compared between the two groups. Multivariate logistic regression analyses were performed to determine which variety influenced ankle functional scores and whether the suprapatellar approach intervention demonstrated a protective effect. Results The mean follow‐up time was 14.22 ± 2.31 months. The mean sagittal section angle of the fracture in the suprapatellar and infrapatellar approach groups was 3.20° ± 1.20° and 5.31° ± 1.23°, respectively (P < 0.001). The mean coronal section angle was 3.51° ± 0.89° and 5.42° ± 1.05°, respectively (P < 0.001). Three patients (4.3%) in the suprapatellar approach group and 15 patients (23.8%) in the infrapatellar approach group had poor fracture reduction (P < 0.001). The mean hind foot functional score and ankle pain score were 95.91 ± 4.70 and 35.91 ± 4.70 points, respectively, in the suprapatellar approach group and 85.20 ± 5.61 and 25.20 ± 5.61 points, respectively, in the infrapatellar approach group (P < 0.001 for both). In the comparison of ankle function, the multivariate logistic regression analyses demonstrated that the odds ratio in the suprapatellar approach group was about 7 times that in the infrapatellar approach group (odds ratio, 7.574; 95% confidence interval, 2.148–28.740; P = 0.002). Of the variants measured, the statistically significant risk factors for poor ankle function were AO type A3 (P = 0.016) and diabetes mellitus (P = 0.006). Sex and the operation interval were not statistically significant risk factors for poor ankle function. Conclusion Intramedullary nailing using the suprapatellar approach facilitates simple fracture reduction, excellent postoperative fracture alignment, and few complications, giving it obvious advantages over the conventional infrapatellar approach. Additionally, the suprapatellar approach is a prognostic factor associated with postoperative ankle joint function.https://doi.org/10.1111/os.13397 |
| spellingShingle | Feng Gao Xiu‐Hui Wang Sheng‐Li Xia Xiao‐Xiao Zhou Ming‐Hui Wang Bei‐Gang Fu Cun‐Guo Yi Sheng‐Yang Guo Intramedullary Nail Fixation by Suprapatellar and Infrapatellar Approaches for Treatment of Distal Tibial Fractures Orthopaedic Surgery |
| title | Intramedullary Nail Fixation by Suprapatellar and Infrapatellar Approaches for Treatment of Distal Tibial Fractures |
| title_full | Intramedullary Nail Fixation by Suprapatellar and Infrapatellar Approaches for Treatment of Distal Tibial Fractures |
| title_fullStr | Intramedullary Nail Fixation by Suprapatellar and Infrapatellar Approaches for Treatment of Distal Tibial Fractures |
| title_full_unstemmed | Intramedullary Nail Fixation by Suprapatellar and Infrapatellar Approaches for Treatment of Distal Tibial Fractures |
| title_short | Intramedullary Nail Fixation by Suprapatellar and Infrapatellar Approaches for Treatment of Distal Tibial Fractures |
| title_sort | intramedullary nail fixation by suprapatellar and infrapatellar approaches for treatment of distal tibial fractures |
| url | https://doi.org/10.1111/os.13397 |
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