Intramedullary Nailing with a Suprapatellar Approach and Condylar Bolts for the Treatment of Bicondylar Fractures of the Tibial Plateau

A case of an adolescent female patient who suffered from first grade open multi-fragment fracture of the tibia (AO42-C2) with a large hypermobile intermediate fragment is presented in this case report. Intramedullary nailing of the tibia remains the treatment of choice despite a high risk of malformation and anterior knee pain especially in multi-fragment fractures. Here the suprapatellar approach as a semiextended nailing technique seems favorable. The specialty in our case was an early change of procedures necessary due to persistent swelling during external fixation based on the hypermobile intermediate fragment. Decision in favor of this surgical technique was conducted in order to achieve beneficial alignment and union while protecting the softtissue despite the hypermobile intermediate fragment and decrease the risk of anterior knee pain. In our case we achieved successful alignment and proper bone healing without any signs of anterior knee pain or limitations in the range of motion of the knee. With this report we would like to recommend the suprapatellar approach as a favorable alternative in intramedullary nailing in this type of fracture also in young patients.

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Intramedullary nailing of tibial shaft fractures in the semi-extended position using a suprapatellar approach: A retrospective case series

Injury ◽

10.1016/j.injury.2018.10.003 ◽

2018 ◽

Vol 49 ◽

pp. S61-S64 ◽

Cited By ~ 9

Author(s):

G. Cazzato ◽

M.F. Saccomanno ◽

G. Noia ◽

G. Masci ◽

M. Peruzzi ◽

...

Keyword(s):

Intramedullary Nailing ◽

Case Series ◽

Tibial Shaft ◽

Retrospective Case ◽

Shaft Fractures ◽

Retrospective Case Series ◽

Extended Position ◽

Suprapatellar Approach ◽

Tibial Shaft Fractures

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Management and incidence of tibial tubercle fractures in bicondylar fractures of the tibial plateau

The Bone & Joint Journal ◽

10.1302/0301-620x.95b12.32016 ◽

2013 ◽

Vol 95-B (12) ◽

pp. 1697-1702 ◽

Cited By ~ 12

Author(s):

M. D. Maroto ◽

J. A. Scolaro ◽

M. B. Henley ◽

R. P. Dunbar

Keyword(s):

Tibial Plateau ◽

Tibial Tubercle ◽

Bicondylar Fractures

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Infrapatellar vs. suprapatellar approach to obtain an optimal insertion angle for intramedullary nailing of tibial fractures

European Journal of Trauma and Emergency Surgery ◽

10.1007/s00068-017-0881-8 ◽

2017 ◽

Vol 44 (6) ◽

pp. 927-938 ◽

Cited By ~ 8

Author(s):

Joerg Franke ◽

Annika Homeier ◽

Lars Metz ◽

Thilo Wedel ◽

Volker Alt ◽

...

Keyword(s):

Intramedullary Nailing ◽

Tibial Fractures ◽

Insertion Angle ◽

Suprapatellar Approach

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Semiextended Intramedullary Nailing of the Tibia Using a Suprapatellar Approach

Journal of Orthopaedic Trauma ◽

10.1097/bot.0000000000000082 ◽

2014 ◽

Vol 28 (5) ◽

pp. 245-255 ◽

Cited By ~ 42

Author(s):

Roy W. Sanders ◽

Thomas G. DiPasquale ◽

Charles J. Jordan ◽

John A. Arrington ◽

H. Claude Sagi

Keyword(s):

Intramedullary Nailing ◽

Suprapatellar Approach

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Application of the Chinese Aircraft-shaped Sleeve system in the treatment of tibial shaft fractures using a suprapatellar approach for tibial intramedullary nailing: a randomised controlled trial

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-018-0995-7 ◽

2018 ◽

Vol 13 (1) ◽

Cited By ~ 4

Author(s):

Ke Lu ◽

Ting-ting Zhou ◽

Yi-jun Gao ◽

Hong-zhen Wang ◽

Zhi-qiang Wu ◽

...

Keyword(s):

Randomised Controlled Trial ◽

Intramedullary Nailing ◽

Controlled Trial ◽

Tibial Shaft ◽

Shaft Fractures ◽

Suprapatellar Approach ◽

Randomised Controlled ◽

Tibial Shaft Fractures

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Intramedullary nailing via suprapatellar approach versus locked plating of proximal extra-articular tibial fractures: a randomized control trial

International Orthopaedics ◽

10.1007/s00264-020-04821-5 ◽

2020 ◽

Cited By ~ 1

Author(s):

Long Cheng ◽

Yan-Hui Li ◽

Yan Chu ◽

Guang Yang ◽

Dong Zhu ◽

...

Keyword(s):

Intramedullary Nailing ◽

Randomized Control Trial ◽

Tibial Fractures ◽

Locked Plating ◽

Suprapatellar Approach ◽

Randomized Control

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F1.2 Complex tibial plateau fractures: how far can we go with intramedullary nailing?

Injury ◽

10.1016/s0020-1383(13)70045-7 ◽

2013 ◽

Vol 44 ◽

pp. S7

Author(s):

C. Garnavos ◽

N. Lasanianos ◽

P. Kakavas ◽

A. Priftis ◽

K. Doudoulakis ◽

...

Keyword(s):

Intramedullary Nailing ◽

Tibial Plateau ◽

Tibial Plateau Fractures

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FUNCTIONAL OUTCOME OF TIBIAL FRACTURES TREATED BY INTERLOCKING NAILING THROUGH SUPRAPATELLAR APPROACH – A PROSPECTIVE AND RETROSPECTIVE STUDY

10.36106/ijsr/2304525 ◽

2021 ◽

pp. 54-55

Author(s):

Dinesh Loganathan ◽

Shivakumar Jeyarajan ◽

B. Sivaraman ◽

M. Venkataraman

Keyword(s):

Functional Outcome ◽

Intramedullary Nailing ◽

Motor Vehicle ◽

Operating Time ◽

Tibial Fractures ◽

Good Reduction ◽

Vehicle Accidents ◽

Suprapatellar Approach ◽

The Mean ◽

Both Bones

The aim of this prospective study is to analyse the functional and radiological outcome of tibial fractures treated by intramedullary nailing through supra patellar approach.15 patients with tibial fractures were operated by intramedullary nailing through suprapatellar approach. Oxford knee scoring system was done to evaluate the functional outcome. Serial radiographs were taken to assess the fracture union at 2 weeks, 6 weeks and 12 weeks. Fifteen patients (male 11 female 4) with fracture both bones leg i Results : ncluded in our study. The most common cause was motor vehicle accidents (9 cases), self limiting fall (4 cases), assault (2 cases). The mean age was 45 years. All fractures united at a mean period of 3.5 months. To conclude, Suprapatellar tibial nailing has the benets of decreased operating time, good ouroscopy visualisation, minimal blood loss and ability to achieve and maintain good reduction throughout the procedure.

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