Work

Comparison of lateral parapatellar vs. infrapatellar approaches for intramedullary nailing for tibial shaft fractures

Year: 2025

Type: article

Abstract: Background This study aimed to evaluate the clinical and functional outcomes of tibial shaft fractures treated with intramedullary nailing (IMN) using the lateral parapatellar entry (LPE) and infrapatellar (IP) surgical approaches. Methods A total of 85 patients with tibial shaft fractures treated with IMN between January 2019 and December 2022 were retrospectively analyzed. A total of 40 and 45 patients underwent IMN using the LPE and IP surgical approaches, respectively. The operation time, intraoperative fluoroscopy times, blood loss, closed reduction rate, fracture healing time and complications were reviewed in this study. The American Orthopaedic Foot and Ankle Society (AOFAS) scale and Lysholm Knee Scoring Scale were used as functional measurements. Results The study included 85 patients (40 in the LPE group and 45 in the IP group), with a minimum follow-up of 12 months. No significant differences were found in fracture healing time, closed reduction rate, infection, deformity healing rate, Lysholm scores, and AOFAS scores between the groups. The LPE group displayed an significantly shorter operation duration, less blood loss, fewer fluoroscopy times, and a lower average VAS score compared to the IP group (P < 0.05). Conclusions The LPE approach for IMN in tibial shaft fractures may offer advantages in terms of fewer fluoroscopy times, and lower complication rates, suggesting it could be a preferable surgical approach.

Source: Frontiers in Surgery

DOI: 10.3389/fsurg.2025.1521860

Authors: Lifeng Yang, Guanghua Nie

Institutions: Xi'an Honghui Hospital, Xi'an Jiaotong University

Language: English

Topic: Bone fractures and treatments

Subfield: Epidemiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801