FUNCTIONAL OUTCOME AND COMPLICATIONS OF BLOCKED TIBIAL INTRAMEDULLARY NAIL WITH SUPRAPATELLAR AND INFRAPATELLAR SURGICAL ACCESS

Abstract

Tibial shaft fractures are common in the lower limb. Its treatment can be carried out through a variety of different methods, such as internal or external fixation. The locked intramedullary tibial nail has been considered the gold standard for fixation, however, chronic knee pain is a frequent postoperative complication of intramedullary tibial nails. The suprapatellar approach is a  variation of the infrapatellar approach for insertion of the tibial intramedullary nail. The present study aims to compare chronic knee pain between traditional infrapatellar access techniques for insertion of an intramedullary tibial nail and the suprapatellar technique. 15 cases of patients with tibial diaphyseal fractures were selected, with a postoperative period of more than 6 months, 9 of which were performed using a suprapatellar access route and 6 using an infrapatellar access route (trans patellar tendon). The Lysholm score, VAS scale, Kendall scale and range of motion were collected. A mean comparison test (Kolmogorov-Smirnov) and frequency comparison (Chi-square) were performed. P values less than 0.05 were considered statistically significant. An average age of 35 years was observed with no statistical differences. There were no significant differences in the analyzed outcomes and no reports of surgical complications. The present study therefore observed that both access methods are effective for the implantation of tibial nails in the treatment of tibial shaft fractures.