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Two tibial nailing techniques may yield equivalent knee symptoms for tibial shaft fractures
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Patients with tibial shaft fractures may experience equivalent knee symptoms but decreased pain when treated with the open, semi-extended, parapatellar tibial nailing technique compared with the traditional infrapatellar tibial nailing technique, according to published results.
Researchers randomly assigned 47 patients with OTA/AO 42A-C tibial shaft fractures to undergo treatment through either an open, semi-extended, parapatellar tibial nailing technique or a traditional infrapatellar tibial nailing technique. Researchers collected age, sex and injury-related data, and patients underwent follow-up at 2 weeks, 6 weeks, 3 months, 6 months and 12 months postoperatively with standard tibial radiographs. A symptoms subset of the IKDC pertaining to knee symptoms and pain was considered the main outcome measure.
Results showed the two groups had no significant differences with regard to demographics, injury or surgery-related variables. Although the two groups had equivalent symptoms scores, researchers found the groups did not have equivalent pain scores. According to results, only Kellgren-Lawrence classification reached statistical significance when comparing demographic and injury-related variables to the symptom subset IKDC. Researchers noted an association between the increasing presence of osteoarthritis and lower Kellgren-Lawrence scores.
“This randomized controlled trial demonstrates that the use of the open semi-extended parapatellar technique for tibial nailing should not be associated with any higher likelihood of knee pain/symptoms than the traditional flexed knee, infrapatellar technique,” the authors wrote. – by Casey Tingle
Disclosures: The authors report no relevant financial disclosures.
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