Comparative Study of Knee Function and Pain Between the Suprapatellar and Medial Parapatellar Approaches After Intramedullary Nailing of a Tibial Fracture
Abstract
Introduction: Anterior knee pain is the most frequent cause of reoperation after intramedullary nailing of a tibial fracture. In recent years, semiextension approaches have simplified the surgical technique, but postoperative pain continues to be the most frequent complication. The aim of this study is to compare the medial parapatellar approach (PPM) vs the suprapatellar approach (SP) with respect to knee pain and postoperative function after intramedullary tibial nailing. Materials and Methods: We retrospectively formed 2 groups of patients with tibial fractures treated with intramedullary nailing through the PPM (n:33) and SP (n:17) approaches. We evaluated postoperative knee pain with the VAS and Lysholm score; and function with the SF-12. They were clinically evaluated at 1, 3, 6 and 12 months. Results: The mean age of the groups was 41.5 years (29-76) for the PPM group and 40.4 years (23-90) for the SP group. Pain and knee function were significantly better in the group of patients operated through the SP approach. Conclusion: The suprapatellar approach is associated with less knee pain and better postoperative function after intramedullary nailing of a tibial fracture. However, prospective studies should validate these results.Downloads
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