Abstract
Purpose
To compare the radiological alignment, union time, union rate, and complication rate between suprapatellar intramedullary nails and minimally invasive locking plate fixation in the treatment of proximal tibial fractures.
Materials and methods
We retrospectively analyzed 103 patients who underwent plate fixation (n = 50) or suprapatellar intramedullary nailing (n = 53) for proximal tibial fractures involving the meta-diaphyseal junction between November 2015 and October 2020 at our institution. The union rate, union time, radiologic alignments, and complications, such as malalignment, nonunion, and deep infection, were investigated.
Results
The demographic data did not differ between the plate and suprapatellar intramedullary nail groups. The alignment of the coronal plane was 0.24 ± 3.19 in the plate group and − 0.49 ± 2.22 in the intramedullary nail group (p = 0.196). Sagittal plane alignment was − 0.29 ± 4.97 in the plate group and 0.24 ± 4.12 in the intramedullary nail group (p = 0.571), and coronal malalignment (p = 0.196), sagittal malalignment (p = 0.57), deep infection (p = 0.264), nonunion (p = 0.695), union time (p = 0.329), and final union rate (p = 0.699) were not significantly different between groups.
Conclusion
Compared with the minimally invasive locking compression plate group, the suprapatellar intramedullary nail group yielded comparable results in terms of radiological alignment and complications. Considering that proximal tibial fractures are associated with high-energy trauma and severe soft tissue damage, we believe that a suprapatellar intramedullary nail may be a good alternative.
Level of evidence
Level III.
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Data availability
The data that support the findings of this study are available from the corresponding author upon reasonable request.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
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This study was approved by the institutional review board of our institution (AJIRB-MED-OBS-16-334), which waived the requirement for informed consent from the patients owing to the retrospective nature of the study.
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Lim, S., Song, H.K., Kim, T.H. et al. Comparison of suprapatellar intramedullary nailing versus minimal invasive locked plating for proximal tibia fractures. Arch Orthop Trauma Surg 143, 7009–7017 (2023). https://doi.org/10.1007/s00402-023-04994-9
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DOI: https://doi.org/10.1007/s00402-023-04994-9