Abstract
Objective: Intramedullary nailing of tibia fractures via a suprapatellar, transarticular approach with the knee joint in 20–30° of flexion and the use of specific protection tubes to preserve intra-articular structures. Indications: Extra-articular fractures of the proximal tibia; simple and comminuted fractures of the tibia diaphysis; segmental diaphyseal fractures of the tibia; extra-articular fractures of the distal tibia and fractures with simple intra-articular distal extension; floating knee injuries. Contraindications: Gustilo grade 3C open fractures of the tibia; severe soft tissue laceration, contamination or infection in the suprapatellar area; ipsilateral knee joint prosthesis; knee arthrodesis; implants blocking the nail entry point. Surgical technique: Via a suprapatellar, transarticular approach an intramedullary tibia nail is inserted after anatomical reposition of the tibial fracture with the knee joint in 20–30° of flexion. Use of specific protection tubes to preserve intra-articular structures. The proximal and distal locking configuration depends upon the specific fracture characteristics. Results: In all, 61 patients underwent suprapatellar tibia nailing and were under follow-up at least until fracture union. Twelve patients suffered from an open fracture. A total of 17 patients had a distal third fracture, 8 sustained a proximal third fracture and 36 had a shaft fracture. Follow-up focused on patients with distal fractures; 6/17 patients sustained open fractures. Average time to union was 9 weeks. One fracture did not heal and required exchange nailing. Two patients complained about anterior knee pain. Functionally, full range of motion was regained in all patients.
Translated title of the contribution | Suprapatellar nailing of fractures of the tibia |
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Original language | English |
Pages (from-to) | 440-454 |
Number of pages | 15 |
Journal | Operative Orthopadie und Traumatologie |
Volume | 32 |
Issue number | 5 |
DOIs | |
State | Published - 1 Oct 2020 |
Externally published | Yes |
Keywords
- Approach
- Bone nails
- Complications
- Expert Tibia Nail®
- Surgical technique