Effect of Internal Fixation of Tibial Fracture with Suprapatellar Approach and Subpatellar Approach on Fracture Union and Knee Function Recovery.

Abstract

Background: The tibia is one of the most vulnerable bones in the human body, accounting for 13.7% of the total fractures. Most tibial fractures (distal articular surface) are caused by high-violence trauma. In recent years, with the rapid development of China's industry, the incidence of tibial fractures has shown an increasing trend.

Aim: To investigate the effect of internal fixation of tibial fractures per suprapatellar approach on fracture union and knee function recovery.

Methods: A total of 100 patients with tibial shaft fractures who underwent operations in our hospital were selected as the subjects. They were divided into a suprapatellar group (suprapatellar approach for intramedullary nail fixation) and a subpatellar group (subpatellar approach for intramedullary nail fixation) according to a prospective randomized study, with 50 cases in each group. The operative time, blood loss, X-ray irradiation times, fracture healing time, postoperative knee pain score, knee Lysholm score, and surgical complication rate were compared between the two groups.

Results: There were no significant differences in operative time, blood loss, and fracture healing time between the suprapatellar and subpatellar groups (P > .05). The number of X-ray irradiations needed and visual analog scale (VAS) scores were lower in the suprapatellar group than those in the subpatellar group (P < .05). The Lysholm score was used to evaluate knee function 6 months postoperatively, and swelling and pain scores were higher in the subpatellar group than in the suprapatellar group (P < .05). However, there were no significant differences in the knee Lysholm total score between the two groups (P > .05). There were also no significant differences in postoperative complications between the two groups (P > .05).

Conclusion: Suprapatellar intramedullary nailing reduced the number of intraoperative X-ray irradiations. Postoperative knee joint pain caused by intramedullary nailing was less, which was beneficial to the early functional knee joint exercise.