Over the last hundred years, there have been significant advancements in the way the Orthopaedic community treats tibial fractures. More recently, the focus of Orthopaedic trauma surgeons has been comparing the different techniques of insertion for tibial nails, specifically suprapatellar (SPTN) versus infrapatellar. The existing literature is convincing that there does not appear to be any clinically significant differences between suprapatellar and infrapatellar tibial nailing, with some apparent benefits of SPTN. Based on the current body of literature and our personal experience with SPTN, we believe the suprapatellar tibial nail will become the future for most tibial nailing procedures, regardless of fracture pattern. We have seen evidence of improved alignment in both proximal and distal fracture patterns, decreased radiation exposure and operative time, relaxation of the deforming forces, ease of imaging, and static positioning of the leg, which would be helpful for the unassisted surgeon, as well as no difference in anterior knee pain or articular damage within the knee between the two techniques.
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http://dx.doi.org/10.3390/jcm12051796 | DOI Listing |
Eur J Trauma Emerg Surg
January 2025
AO Research Institute Davos, Davos, Switzerland.
Background: Digitally Enhanced Hands-on Surgical Training (DEHST) platform was introduced to overcome the lack of training capabilities for the challenging task of freehand distal interlocking of intramedullary nails. It demonstrates high perceived realism for surgeons, and novices perform significantly better after DEHST training. However, characterization of how performance improves remained unexplored.
View Article and Find Full Text PDFInt J Surg Case Rep
December 2024
Joint Reconstruction Research Center (JRRC), Imam Khomeini Hospital, Tehran University of Medical Sciences, End of Keshavarz Blvd, 1419733141 Tehran, Iran. Electronic address:
Introduction: Heterotopic ossification (HO) is the formation of mature bone in soft tissue, often occurring after fractures and trauma. Patients with HO experience pain, joint stiffness, and other complications. Treatment aims to improve function; surgical procedures have succeeded in 83.
View Article and Find Full Text PDFJB JS Open Access
January 2025
Saint Francis Health System, Trauma Institute, Tulsa, Oklahoma.
Background: Tibial shaft fractures are common, causing substantial morbidity. Intramedullary nailing offers advantages but often leads to anterior knee pain and functional issues.
Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a systematic review on outcomes for different surgical approaches-suprapatellar (SP), infrapatellar (IP), medial parapatellar (MPP), and lateral parapatellar (LPP).
J Orthop Trauma
January 2025
Geisinger Health System, Department of Orthopaedic Surgery, Danville, PA.
Objectives: To explore outcomes after tibial rigid intramedullary nailing (RIMN) in skeletally immature patients, with a focus on post-operative complications and iatrogenic changes in tibial slope due to anterior physeal arrest.
Methods: Design: Retrospective case series.
Setting: A large, tertiary care health system in the rural Mid-Atlantic United States, including two Level 1 trauma centers and one Level 2 trauma center.
Int J Surg
January 2025
Department of Orthopedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Purpose: Congenital pseudarthrosis of the tibia (CPT) is a rare condition typically manifesting within the first decade of life. The primary objectives of surgical intervention for CPT include achieving long-term bony union of the tibia, preventing or minimizing limb length discrepancies (LLD), avoiding mechanical axis deviations of the tibia and adjacent joints, and preventing refracture. This study aims to conduct a systematic review of current treatment methods for CPT to determine the most effective non-surgical and surgical management strategies for pediatric patients with this condition.
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