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A retrospective investigation on clinical and radiographic outcomes of distal tibial fractures after intramedullary nailing using the lateral parapatellar extra-articular approach
Introduction According to reports, the modified extra-articular parapatellar approach allows the performance of tibial nailing in the semi-extended position without the concern of joint violation. However, there remains no special study that has provided a detailed assessment of the benefits and ris...
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| Published in: | Archives of orthopaedic and trauma surgery 2024-05, Vol.144 (5), p.2101-2108 |
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| creator | Nie, Wei Wang, Zhaojun Xu, Shizhuang Guo, Sutong Yue, Yang Sun, Kefu |
| description | Introduction
According to reports, the modified extra-articular parapatellar approach allows the performance of tibial nailing in the semi-extended position without the concern of joint violation. However, there remains no special study that has provided a detailed assessment of the benefits and risks of this approach for treating distal tibial fractures (DTFs). The aim of this retrospective study was to investigate the clinical and radiological outcomes of patients with DTFs after intramedullary nailing using a lateral parapatellar extra-articular (LPE) approach in comparison to using the suprapatellar (SP) and transpatellar (TP) approaches.
Methods
Data were collected from 99 patients with a minimum follow-up period of 12 months. Comparisons were conducted between the groups regarding the number of intraoperative fluoroscopies, complications, knee pain, knee range of motion (ROM), the Lysholm Knee Scale (LKS), the Olerud-Molander Ankle Score (OMAS) and radiological findings.
Results
The demographic characteristics were comparable between the groups. Fewer intraoperative fluoroscopies were performed in the LPE (27.47 ± 4.98) and SP (26.03 ± 5.12) groups than in the TP group (30.20 ± 7.42;
P |
| doi_str_mv | 10.1007/s00402-024-05344-z |
| format | article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_11093779</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3045114696</sourcerecordid><originalsourceid>FETCH-LOGICAL-c426t-c2ce882c168609aa59a20c13b57afd2c02d2fd177894f4eae0ff6223871b8ff73</originalsourceid><addsrcrecordid>eNp9ks1u1TAQhSNERUvhBVggS2zYhPovjrNCVcWfVKmbsrbmOnauq9w42M5V6Wvxgky4pRQWSFE81nxz7JOcqnrF6DtGaXuWKZWU15TLmjZCyvruSXXCpJC16Jh6-qg-rp7nfEMp47qjz6pjoVUjtNAn1Y9zklxJMc_OlrB3JEx7l0sYoIQ4EXzsGKZgYSQw9SRBH-KQYN4GS-JSbNy5TKInfcgFmRI2ARefwJYlYQt8cQlFS4Kd65dxhPSdTBBQdCBLXt9l68gIiOHgDKiN9coRd4tTNaQS7LLuYZ5TBLt9UR15GLN7eb-eVl8_fri--FxfXn36cnF-WVvJVaktt05rbpnSinYATQecWiY2TQu-55bynvueta3upJcOHPVecS50yzba-1acVu8PuvOywctbt7oYzZzCDl2YCMH83ZnC1gxxbxijnWjbDhXe3iuk-G3B72p2IdvV3eTiko2gsmFMqk4h-uYf9CYuaUJ_SDVSNaxhHCl-oCz-spycf7gNo2YNhTmEwmAozK9QmDscev3Yx8PI7xQgIA5AxtY0uPTn7P_I_gRrMMmk</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3054651512</pqid></control><display><type>article</type><title>A retrospective investigation on clinical and radiographic outcomes of distal tibial fractures after intramedullary nailing using the lateral parapatellar extra-articular approach</title><source>Springer Nature</source><creator>Nie, Wei ; Wang, Zhaojun ; Xu, Shizhuang ; Guo, Sutong ; Yue, Yang ; Sun, Kefu</creator><creatorcontrib>Nie, Wei ; Wang, Zhaojun ; Xu, Shizhuang ; Guo, Sutong ; Yue, Yang ; Sun, Kefu</creatorcontrib><description>Introduction
According to reports, the modified extra-articular parapatellar approach allows the performance of tibial nailing in the semi-extended position without the concern of joint violation. However, there remains no special study that has provided a detailed assessment of the benefits and risks of this approach for treating distal tibial fractures (DTFs). The aim of this retrospective study was to investigate the clinical and radiological outcomes of patients with DTFs after intramedullary nailing using a lateral parapatellar extra-articular (LPE) approach in comparison to using the suprapatellar (SP) and transpatellar (TP) approaches.
Methods
Data were collected from 99 patients with a minimum follow-up period of 12 months. Comparisons were conducted between the groups regarding the number of intraoperative fluoroscopies, complications, knee pain, knee range of motion (ROM), the Lysholm Knee Scale (LKS), the Olerud-Molander Ankle Score (OMAS) and radiological findings.
Results
The demographic characteristics were comparable between the groups. Fewer intraoperative fluoroscopies were performed in the LPE (27.47 ± 4.98) and SP (26.03 ± 5.12) groups than in the TP group (30.20 ± 7.42;
P
<0.001). When compared with the other two approaches, the LPE approach was associated with less knee pain (
P
<0.001) and better knee ROM (
P
<0.001) at one week postoperative. No significant intergroup differences were detected in the incidence of complications, LKS scores (
P
= 0.687) and OMAS (
P
= 0.926). Radiological findings demonstrated that postoperative tibial alignment (
P
= 0.853), the time of bony union and rate of non-union were similar between the groups.
Conclusion
The LPE approach can serve as a safe and effective option for tibial nailing, as it offers favourable outcomes in knee pain relief and knee ROM in the early postoperative period and is equivalent to the other two approaches in terms of the incidence of complications, fracture healing, functional recovery and postoperative alignment for patients with DTFs.</description><identifier>ISSN: 1434-3916</identifier><identifier>ISSN: 0936-8051</identifier><identifier>EISSN: 1434-3916</identifier><identifier>DOI: 10.1007/s00402-024-05344-z</identifier><identifier>PMID: 38653838</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Aged ; Female ; Fracture Fixation, Intramedullary - adverse effects ; Fracture Fixation, Intramedullary - methods ; Humans ; Knee ; Knee Joint - diagnostic imaging ; Knee Joint - surgery ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Orthopaedic Surgery ; Orthopedics ; Patella - diagnostic imaging ; Patella - injuries ; Patella - surgery ; Radiography ; Range of Motion, Articular ; Retrospective Studies ; Tibial Fractures - diagnostic imaging ; Tibial Fractures - surgery ; Treatment Outcome</subject><ispartof>Archives of orthopaedic and trauma surgery, 2024-05, Vol.144 (5), p.2101-2108</ispartof><rights>The Author(s) 2024</rights><rights>2024. The Author(s).</rights><rights>The Author(s) 2024. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c426t-c2ce882c168609aa59a20c13b57afd2c02d2fd177894f4eae0ff6223871b8ff73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38653838$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nie, Wei</creatorcontrib><creatorcontrib>Wang, Zhaojun</creatorcontrib><creatorcontrib>Xu, Shizhuang</creatorcontrib><creatorcontrib>Guo, Sutong</creatorcontrib><creatorcontrib>Yue, Yang</creatorcontrib><creatorcontrib>Sun, Kefu</creatorcontrib><title>A retrospective investigation on clinical and radiographic outcomes of distal tibial fractures after intramedullary nailing using the lateral parapatellar extra-articular approach</title><title>Archives of orthopaedic and trauma surgery</title><addtitle>Arch Orthop Trauma Surg</addtitle><addtitle>Arch Orthop Trauma Surg</addtitle><description>Introduction
According to reports, the modified extra-articular parapatellar approach allows the performance of tibial nailing in the semi-extended position without the concern of joint violation. However, there remains no special study that has provided a detailed assessment of the benefits and risks of this approach for treating distal tibial fractures (DTFs). The aim of this retrospective study was to investigate the clinical and radiological outcomes of patients with DTFs after intramedullary nailing using a lateral parapatellar extra-articular (LPE) approach in comparison to using the suprapatellar (SP) and transpatellar (TP) approaches.
Methods
Data were collected from 99 patients with a minimum follow-up period of 12 months. Comparisons were conducted between the groups regarding the number of intraoperative fluoroscopies, complications, knee pain, knee range of motion (ROM), the Lysholm Knee Scale (LKS), the Olerud-Molander Ankle Score (OMAS) and radiological findings.
Results
The demographic characteristics were comparable between the groups. Fewer intraoperative fluoroscopies were performed in the LPE (27.47 ± 4.98) and SP (26.03 ± 5.12) groups than in the TP group (30.20 ± 7.42;
P
<0.001). When compared with the other two approaches, the LPE approach was associated with less knee pain (
P
<0.001) and better knee ROM (
P
<0.001) at one week postoperative. No significant intergroup differences were detected in the incidence of complications, LKS scores (
P
= 0.687) and OMAS (
P
= 0.926). Radiological findings demonstrated that postoperative tibial alignment (
P
= 0.853), the time of bony union and rate of non-union were similar between the groups.
Conclusion
The LPE approach can serve as a safe and effective option for tibial nailing, as it offers favourable outcomes in knee pain relief and knee ROM in the early postoperative period and is equivalent to the other two approaches in terms of the incidence of complications, fracture healing, functional recovery and postoperative alignment for patients with DTFs.</description><subject>Adult</subject><subject>Aged</subject><subject>Female</subject><subject>Fracture Fixation, Intramedullary - adverse effects</subject><subject>Fracture Fixation, Intramedullary - methods</subject><subject>Humans</subject><subject>Knee</subject><subject>Knee Joint - diagnostic imaging</subject><subject>Knee Joint - surgery</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Orthopaedic Surgery</subject><subject>Orthopedics</subject><subject>Patella - diagnostic imaging</subject><subject>Patella - injuries</subject><subject>Patella - surgery</subject><subject>Radiography</subject><subject>Range of Motion, Articular</subject><subject>Retrospective Studies</subject><subject>Tibial Fractures - diagnostic imaging</subject><subject>Tibial Fractures - surgery</subject><subject>Treatment Outcome</subject><issn>1434-3916</issn><issn>0936-8051</issn><issn>1434-3916</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9ks1u1TAQhSNERUvhBVggS2zYhPovjrNCVcWfVKmbsrbmOnauq9w42M5V6Wvxgky4pRQWSFE81nxz7JOcqnrF6DtGaXuWKZWU15TLmjZCyvruSXXCpJC16Jh6-qg-rp7nfEMp47qjz6pjoVUjtNAn1Y9zklxJMc_OlrB3JEx7l0sYoIQ4EXzsGKZgYSQw9SRBH-KQYN4GS-JSbNy5TKInfcgFmRI2ARefwJYlYQt8cQlFS4Kd65dxhPSdTBBQdCBLXt9l68gIiOHgDKiN9coRd4tTNaQS7LLuYZ5TBLt9UR15GLN7eb-eVl8_fri--FxfXn36cnF-WVvJVaktt05rbpnSinYATQecWiY2TQu-55bynvueta3upJcOHPVecS50yzba-1acVu8PuvOywctbt7oYzZzCDl2YCMH83ZnC1gxxbxijnWjbDhXe3iuk-G3B72p2IdvV3eTiko2gsmFMqk4h-uYf9CYuaUJ_SDVSNaxhHCl-oCz-spycf7gNo2YNhTmEwmAozK9QmDscev3Yx8PI7xQgIA5AxtY0uPTn7P_I_gRrMMmk</recordid><startdate>20240501</startdate><enddate>20240501</enddate><creator>Nie, Wei</creator><creator>Wang, Zhaojun</creator><creator>Xu, Shizhuang</creator><creator>Guo, Sutong</creator><creator>Yue, Yang</creator><creator>Sun, Kefu</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20240501</creationdate><title>A retrospective investigation on clinical and radiographic outcomes of distal tibial fractures after intramedullary nailing using the lateral parapatellar extra-articular approach</title><author>Nie, Wei ; Wang, Zhaojun ; Xu, Shizhuang ; Guo, Sutong ; Yue, Yang ; Sun, Kefu</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c426t-c2ce882c168609aa59a20c13b57afd2c02d2fd177894f4eae0ff6223871b8ff73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Female</topic><topic>Fracture Fixation, Intramedullary - adverse effects</topic><topic>Fracture Fixation, Intramedullary - methods</topic><topic>Humans</topic><topic>Knee</topic><topic>Knee Joint - diagnostic imaging</topic><topic>Knee Joint - surgery</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Orthopaedic Surgery</topic><topic>Orthopedics</topic><topic>Patella - diagnostic imaging</topic><topic>Patella - injuries</topic><topic>Patella - surgery</topic><topic>Radiography</topic><topic>Range of Motion, Articular</topic><topic>Retrospective Studies</topic><topic>Tibial Fractures - diagnostic imaging</topic><topic>Tibial Fractures - surgery</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nie, Wei</creatorcontrib><creatorcontrib>Wang, Zhaojun</creatorcontrib><creatorcontrib>Xu, Shizhuang</creatorcontrib><creatorcontrib>Guo, Sutong</creatorcontrib><creatorcontrib>Yue, Yang</creatorcontrib><creatorcontrib>Sun, Kefu</creatorcontrib><collection>SpringerOpen</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Archives of orthopaedic and trauma surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nie, Wei</au><au>Wang, Zhaojun</au><au>Xu, Shizhuang</au><au>Guo, Sutong</au><au>Yue, Yang</au><au>Sun, Kefu</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A retrospective investigation on clinical and radiographic outcomes of distal tibial fractures after intramedullary nailing using the lateral parapatellar extra-articular approach</atitle><jtitle>Archives of orthopaedic and trauma surgery</jtitle><stitle>Arch Orthop Trauma Surg</stitle><addtitle>Arch Orthop Trauma Surg</addtitle><date>2024-05-01</date><risdate>2024</risdate><volume>144</volume><issue>5</issue><spage>2101</spage><epage>2108</epage><pages>2101-2108</pages><issn>1434-3916</issn><issn>0936-8051</issn><eissn>1434-3916</eissn><abstract>Introduction
According to reports, the modified extra-articular parapatellar approach allows the performance of tibial nailing in the semi-extended position without the concern of joint violation. However, there remains no special study that has provided a detailed assessment of the benefits and risks of this approach for treating distal tibial fractures (DTFs). The aim of this retrospective study was to investigate the clinical and radiological outcomes of patients with DTFs after intramedullary nailing using a lateral parapatellar extra-articular (LPE) approach in comparison to using the suprapatellar (SP) and transpatellar (TP) approaches.
Methods
Data were collected from 99 patients with a minimum follow-up period of 12 months. Comparisons were conducted between the groups regarding the number of intraoperative fluoroscopies, complications, knee pain, knee range of motion (ROM), the Lysholm Knee Scale (LKS), the Olerud-Molander Ankle Score (OMAS) and radiological findings.
Results
The demographic characteristics were comparable between the groups. Fewer intraoperative fluoroscopies were performed in the LPE (27.47 ± 4.98) and SP (26.03 ± 5.12) groups than in the TP group (30.20 ± 7.42;
P
<0.001). When compared with the other two approaches, the LPE approach was associated with less knee pain (
P
<0.001) and better knee ROM (
P
<0.001) at one week postoperative. No significant intergroup differences were detected in the incidence of complications, LKS scores (
P
= 0.687) and OMAS (
P
= 0.926). Radiological findings demonstrated that postoperative tibial alignment (
P
= 0.853), the time of bony union and rate of non-union were similar between the groups.
Conclusion
The LPE approach can serve as a safe and effective option for tibial nailing, as it offers favourable outcomes in knee pain relief and knee ROM in the early postoperative period and is equivalent to the other two approaches in terms of the incidence of complications, fracture healing, functional recovery and postoperative alignment for patients with DTFs.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>38653838</pmid><doi>10.1007/s00402-024-05344-z</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| source | Springer Nature |
| subjects | Adult Aged Female Fracture Fixation, Intramedullary - adverse effects Fracture Fixation, Intramedullary - methods Humans Knee Knee Joint - diagnostic imaging Knee Joint - surgery Male Medicine Medicine & Public Health Middle Aged Orthopaedic Surgery Orthopedics Patella - diagnostic imaging Patella - injuries Patella - surgery Radiography Range of Motion, Articular Retrospective Studies Tibial Fractures - diagnostic imaging Tibial Fractures - surgery Treatment Outcome |
| title | A retrospective investigation on clinical and radiographic outcomes of distal tibial fractures after intramedullary nailing using the lateral parapatellar extra-articular approach |
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