217 / 245
DOS Kongressen 2016 ·
217
Outcome following suprapatellar approach to tibia
nailing.
Ole Brink
Orthopaedic Surgery - Traumatology, Aarhus University Hospital
Background:
Intramedullary nailing of the tibia using a suprapatellar approach
(SPI) has become more popular in the past years. Advantages of the technique
is easier nailing of the proximal and distal fractures and easier positioning of the
patient. Few studies have yet evaluated the outcome.
Purpose / Aim of Study:
The aim of this prospective study was to evaluate
the operative experience, clinical and patient’s subjective outcome following SPI
nailing.
Materials and Methods:
Forty-five consecutive patient with tibia fractures
and treated with SPI nailing using were included. Eight patient were admitted
as poly-trauma, and five patients were habitual mobilized in wheelchair. After a
minimum follow-up of 1 year all alive patients were asked to complete a ques-
tionnaire. Lysholm score, EQ-5D and VAS pain score were used to evaluate
functional outcome and health status.
Findings / Results:
Twenty-eight patients were treated with Trigen Tibial Nail
(Smith & Nephew) and 17 with T2 Tibial Nail (Stryker). Patients average age
was 55 (range: 17-91). Seven fractures were OTA-AO type A, 32 type B and
6 type C. Ten fractures were open, including 4 Gustilo grade III. Mean oper-
ating time was 100 minutes (range: 28-295). There were no intraoperative
complications. One patient in anticoagulant therapy developed haemarthrosis
postoperatively. One fracture had delayed union and healed after change of
locking screws. Four patients died before follow-up and among 41 eligble 25
completed the questionnaire with a mean followup time of 749 days. Average
pain analogue score while walking (if walking) was 3.18, Lysholm score = 69 (CI:
59-78) and EQ-5D = 60 (CI: 49-72).
Conclusions:
In this heterogen population the results indicate that SPI is a use-
ful and safe procedure for treating tibial fractures, and patient outcome is com-
parable to studies evaluating infrapatellar nailing.
No conflicts of interest reported
168.