OTA 2023: IM Nailing via Suprapatellar vs. Infrapatellar Approach for Acute Tibial Shaft Fractures .
Reduced Anterior Knee Pain and Improved Function Following Suprapatellar Versus Infrapatellar Intramedullary Nailing of the Tibia: Results of a Randomized Controlled Trial
90 acute tibial shaft fractures were included in this randomized trial comparing intramedullary nailing via a suprapatellar approach (n=42) or infrapatellar approach (n=48). The primary outcomes of interest included anterior knee pain on a Visual Analog Scale (VAS) and knee function on the Kujala scale, measured at 6 weeks and 12 months. Secondary outcomes of interest included radiographic alignment, radiation exposure, and non-union. Patients who received suprapatellar intramedullary nailing reported significantly less anterior knee pain and better knee function at both 6 weeks and 12 months (p<0.05 for all). Moreover, significantly less radiation exposure and lower rates of malalignment were observed in the suprapatellar group.
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