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DOS Kongressen 2017 ·
169
Knee pain after tibial shaft fracture treated with
intramedullary nailing in a 6-year follow-up of 223
cases.
Nikolaj Erin-Madsen, Bjarke Viberg, Tobias Kvanner Aasvang, Thomas Bloch, Mi-
chael Brix, Peter Toft Tengberg
Department of Orthopedic Surgery, Herlev Hospital; Department of Orthopedic
Surgery, Kolding Hospital; Department of Orthopedic Surgery, University Hos-
pital of Hvidovre; Department of Orthopedic Surgery, Slagelse Hospital; De-
partment of Orthopedic Surgery, University Hospital of Odense; Department of
Orthopedic Surgery, University Hospital of Hvidovre
Background:
The treatment of choice for unstable diaphyseal fractures in the
tibia is reamed insertion of an intramedullary nail (IMN) with the additional
placement of interlocking screws. The most common complication after inser-
tion of an IMN as treatment of tibial shaft fractures is chronic knee pain with
reported rates between 10 % and 87 % with a mean of 47,4 % in metaanalyses.
Purpose / Aim of Study:
The primary objective of this study is to evaluate the
long-term outcome after inserting an IMN in patients with a tibial shaft fracture
using an injury-specific questionnaire.
Materials and Methods:
This study includes patients operated on five Danish
hospitals. A database search was made using operational codes for insertion of
an IMN in a five- year period. All patients who had undergone surgery with the
insertion of an IMN in the tibia were included. Patients then received a KOOS-
questionnaire by mail with questions regarding knee-specific symptoms, stiff-
ness, pain, function and life quality. Questionnaires were filled out and returned
to the corresponding physician for further analyze.
Findings / Results:
A total of 351 patients were found eligible to enter the
study. Questionnaires were sent out and 236 patients responded. 13 did not
meet the inclusion criteria and were excluded. 223 (63,5%) patient question-
naires were analyzed. Mean age was 47,9 years at the time of surgery. 63 %
were men and 37% women. Follow-up time ranged from 1,7 to 6,7 years. Pa-
tients in this study reported worse KOOS- scores than the reference population
in all subscales.
Conclusions:
With a follow-up time of over 6 years after IMN of tibia shaft
fractures, patients experience more knee- specific symptoms, pain, limitations
in sports and daily living and the study population reported lower scores of qual-
ity of life compared with a reference population.
No conflicts of interest reported
121.