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Lower rate of malalignment found with suprapatellar IM nail insertion technique
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Patients with distal tibia fractures treated with a suprapatellar intramedullary nailing method had a significantly lower rate of malalignment compared with use of an infrapatellar intramedullary nail technique, according to results.
Researchers categorized 266 patients with tibia fractures into two groups: patients treated using a suprapatellar intramedullary nail (IMN) insertion technique (49.6%); and patients who underwent IMN placement with an infrapatellar technique (50.4%). Researchers measured anatomic alignment of the tibia on anteroposterior and lateral tibia radiographs obtained following surgical fixation.
Results showed the fibula was intact in 4.5% of patients in the suprapatellar group, fixed in 16.7% and remained fractured in 78.8% compared with 6.7%, 23.9% and 69.4% of patients, respectively, in the infrapatellar group. Researchers found no significant difference in the rate of fibular fixation between the groups.
According to results, 26.1% of patients who underwent infrapatellar IMN insertion experienced primary angular malalignment vs. 3.8% of patients who underwent suprapatellar IMN insertion. While the two groups had no statistical difference in the rate of blocking screws, percutaneous clamp-assisted reduction or provisional plating used, results showed a statistically significant difference when comparing any adjuvant technique vs. no intervention. Researchers found a statistically significant difference in alignment in both the coronal and sagittal planes between the two groups. – by Casey Tingle
Disclosures: Avilucea reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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