Comparison of the efficacy of intramedullary nailing via the lateral parapatellar approach versus the infrapatellar approach in the treatment of tibial metaphyseal-diaphyseal junction fractures
Abstract Background To compare the efficacy of intramedullary nailing via the lateral parapatellar approach versus the infrapatellar approach in treating fractures at the tibial metaphyseal-diaphyseal junction. Methods A retrospective analysis was conducted on the clinical data of 45 patients with p...
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BMC
2024-12-01
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| Series: | Journal of Orthopaedic Surgery and Research |
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| Online Access: | https://doi.org/10.1186/s13018-024-05338-y |
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| author | Xin Cao Qingxiang Tang Bingxin Zhou Wei Xiao Huijin Chen |
| author_facet | Xin Cao Qingxiang Tang Bingxin Zhou Wei Xiao Huijin Chen |
| author_sort | Xin Cao |
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| description | Abstract Background To compare the efficacy of intramedullary nailing via the lateral parapatellar approach versus the infrapatellar approach in treating fractures at the tibial metaphyseal-diaphyseal junction. Methods A retrospective analysis was conducted on the clinical data of 45 patients with proximal or distal tibial fractures treated with intramedullary nailing via lateral parapatellar approach (n = 23) or infrapatellar approach (n = 22) between January 2019 and March 2023. We recorded and compared the operative time, intraoperative blood loss/fluoroscopies, success rate of closed reduction, anteroposterior and lateral entry point accuracy, postoperative infection, fracture healing time, as well as NRS pain scores, Lysholm knee function scores, and knee range of motion. Results Both groups completed the surgery without any complications. The lateral parapatellar approach group had significantly better results regarding shorter operative time, less intraoperative blood loss, and fewer intraoperative fluoroscopies compared to the infrapatellar approach group (P < 0.05). All cases in the lateral parapatellar approach group achieved closed reduction, while 10 cases in the infrapatellar approach group required open reduction. Fractures in both groups healed successfully, without statistically difference in healing time (P > 0.05). The accuracy of anteroposterior and lateral entry points was better with lateral parapatellar approach (P < 0.05). At 3 and 12 months postoperatively, lateral parapatellar approach showed better Lysholm and NRS scores compared to infrapatellar approach (P < 0.05). Two groups had no significant difference in range of motion (P > 0.05). Conclusions Lateral parapatellar approach combined with the blocking screw technique provides superior clinical outcomes compared to infrapatellar approach in the treatment of proximal or distal tibial fractures, making it suitable for further investigation. |
| format | Article |
| id | doaj-art-ec32961a3e904a69b20905ecc196fd9f |
| institution | Kabale University |
| issn | 1749-799X |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj-art-ec32961a3e904a69b20905ecc196fd9f2024-12-22T12:37:14ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2024-12-0119111110.1186/s13018-024-05338-yComparison of the efficacy of intramedullary nailing via the lateral parapatellar approach versus the infrapatellar approach in the treatment of tibial metaphyseal-diaphyseal junction fracturesXin Cao0Qingxiang Tang1Bingxin Zhou2Wei Xiao3Huijin Chen4Department of Traumatic Orthopedics, Shengli Oilfield Central HospitalDepartment of Traumatic Orthopedics, Shengli Oilfield Central HospitalDepartment of Clinical Laboratory, Shengli Oilfield Central HospitalDepartment of Orthopedic, People’s Hospital of Xinjiang Uygur Autonomous RegionDepartment of Clinical Laboratory, Shengli Oilfield Central HospitalAbstract Background To compare the efficacy of intramedullary nailing via the lateral parapatellar approach versus the infrapatellar approach in treating fractures at the tibial metaphyseal-diaphyseal junction. Methods A retrospective analysis was conducted on the clinical data of 45 patients with proximal or distal tibial fractures treated with intramedullary nailing via lateral parapatellar approach (n = 23) or infrapatellar approach (n = 22) between January 2019 and March 2023. We recorded and compared the operative time, intraoperative blood loss/fluoroscopies, success rate of closed reduction, anteroposterior and lateral entry point accuracy, postoperative infection, fracture healing time, as well as NRS pain scores, Lysholm knee function scores, and knee range of motion. Results Both groups completed the surgery without any complications. The lateral parapatellar approach group had significantly better results regarding shorter operative time, less intraoperative blood loss, and fewer intraoperative fluoroscopies compared to the infrapatellar approach group (P < 0.05). All cases in the lateral parapatellar approach group achieved closed reduction, while 10 cases in the infrapatellar approach group required open reduction. Fractures in both groups healed successfully, without statistically difference in healing time (P > 0.05). The accuracy of anteroposterior and lateral entry points was better with lateral parapatellar approach (P < 0.05). At 3 and 12 months postoperatively, lateral parapatellar approach showed better Lysholm and NRS scores compared to infrapatellar approach (P < 0.05). Two groups had no significant difference in range of motion (P > 0.05). Conclusions Lateral parapatellar approach combined with the blocking screw technique provides superior clinical outcomes compared to infrapatellar approach in the treatment of proximal or distal tibial fractures, making it suitable for further investigation.https://doi.org/10.1186/s13018-024-05338-yTibial metaphyseal-diaphyseal junction fracturesLateral parapatellar approachBlocking screw techniqueSurgery |
| spellingShingle | Xin Cao Qingxiang Tang Bingxin Zhou Wei Xiao Huijin Chen Comparison of the efficacy of intramedullary nailing via the lateral parapatellar approach versus the infrapatellar approach in the treatment of tibial metaphyseal-diaphyseal junction fractures Journal of Orthopaedic Surgery and Research Tibial metaphyseal-diaphyseal junction fractures Lateral parapatellar approach Blocking screw technique Surgery |
| title | Comparison of the efficacy of intramedullary nailing via the lateral parapatellar approach versus the infrapatellar approach in the treatment of tibial metaphyseal-diaphyseal junction fractures |
| title_full | Comparison of the efficacy of intramedullary nailing via the lateral parapatellar approach versus the infrapatellar approach in the treatment of tibial metaphyseal-diaphyseal junction fractures |
| title_fullStr | Comparison of the efficacy of intramedullary nailing via the lateral parapatellar approach versus the infrapatellar approach in the treatment of tibial metaphyseal-diaphyseal junction fractures |
| title_full_unstemmed | Comparison of the efficacy of intramedullary nailing via the lateral parapatellar approach versus the infrapatellar approach in the treatment of tibial metaphyseal-diaphyseal junction fractures |
| title_short | Comparison of the efficacy of intramedullary nailing via the lateral parapatellar approach versus the infrapatellar approach in the treatment of tibial metaphyseal-diaphyseal junction fractures |
| title_sort | comparison of the efficacy of intramedullary nailing via the lateral parapatellar approach versus the infrapatellar approach in the treatment of tibial metaphyseal diaphyseal junction fractures |
| topic | Tibial metaphyseal-diaphyseal junction fractures Lateral parapatellar approach Blocking screw technique Surgery |
| url | https://doi.org/10.1186/s13018-024-05338-y |
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