Suprapatellar nailing of fractures of the tibia.

Objective: Intramedullary nailing of tibia fractures via a suprapatellar, transarticular approach with the knee joint in 20-30° of flexion and the use of specific protection tubes to preserve intra-articular structures.

Indications: Extra-articular fractures of the proximal tibia; simple and comminuted fractures of the tibia diaphysis; segmental diaphyseal fractures of the tibia; extra-articular fractures of the distal tibia and fractures with simple intra-articular distal extension; floating knee injuries.

Contraindications: Gustilo grade 3C open fractures of the tibia; severe soft tissue laceration, contamination or infection in the suprapatellar area; ipsilateral knee joint prosthesis; knee arthrodesis; implants blocking the nail entry point.