Intramedullary nailing of tibial shaft fractures in the semi-extended position using a suprapatellar portal technique

Intramedullary nailing of tibial shaft fractures in the semi-extended position using a... Intramedullary nail fixation remains the standard treatment for displaced tibial shaft fractures. Establishing an appropriate starting point remains a crucial step in the surgical procedure. Tibial nailing using an infrapatellar starting point with the knee flexed over a radiolucent triangle has been established as a widely-used standard technique. Tibial nail insertion with the knee in the semi-extended position was introduced with the goal to counteract post-operative procurvatum deformities that frequently have been reported as a common problem in proximal third tibial shaft fractures. Early reports on tibial nailing in the semi-extended position used a knee arthrotomy in order to establish the proximal tibial starting point. Recent technological advances have provided the surgical community with instrumentation systems that allow for tibial nailing in the semi-extended position using a suprapatellar portal with nail insertion through the patellofemoral joint. Preliminary clinical studies have suggested favorable outcomes that can be achieved with this technique. This article provides a description of the surgical technique and a review of the currently available evidence. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png International Orthopaedics Springer Journals

Intramedullary nailing of tibial shaft fractures in the semi-extended position using a suprapatellar portal technique

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Publisher
Springer Berlin Heidelberg
Copyright
Copyright © 2017 by SICOT aisbl
Subject
Medicine & Public Health; Orthopedics
ISSN
0341-2695
eISSN
1432-5195
D.O.I.
10.1007/s00264-017-3457-7
Publisher site
See Article on Publisher Site

Abstract

Intramedullary nail fixation remains the standard treatment for displaced tibial shaft fractures. Establishing an appropriate starting point remains a crucial step in the surgical procedure. Tibial nailing using an infrapatellar starting point with the knee flexed over a radiolucent triangle has been established as a widely-used standard technique. Tibial nail insertion with the knee in the semi-extended position was introduced with the goal to counteract post-operative procurvatum deformities that frequently have been reported as a common problem in proximal third tibial shaft fractures. Early reports on tibial nailing in the semi-extended position used a knee arthrotomy in order to establish the proximal tibial starting point. Recent technological advances have provided the surgical community with instrumentation systems that allow for tibial nailing in the semi-extended position using a suprapatellar portal with nail insertion through the patellofemoral joint. Preliminary clinical studies have suggested favorable outcomes that can be achieved with this technique. This article provides a description of the surgical technique and a review of the currently available evidence.

Journal

International OrthopaedicsSpringer Journals

Published: Mar 30, 2017

References

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