Comparative analysis of suprapatellar vs infrapatellar approaches in intramedullary nailing for distal tibia fractures

Ankur Ojha; Pushprajan; Prince Maheshwari; Ajit Singh

doi:10.18203/issn.2455-4510.IntJResOrthop20250458

Authors

Ankur Ojha Department of Orthopaedics, Heritage IMS, Varanasi, Uttar Pradesh, India
Pushprajan Department of Orthopaedics, KGMU, Lucknow, Uttar Pradesh, India
Prince Maheshwari Department of Orthopaedics, IMS BHU, Varanasi, Uttar Pradesh, India
Ajit Singh Department of Orthopaedics, IMS BHU, Varanasi, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20250458

Keywords:

American orthopaedic foot and ankle society score, Distal tibia fractures, Infrapatellar nailing, Pain score , Suprapatellar nailing, Surgical time

Abstract

Background: The current study delves into the clinical and functional outcomes of suprapatellar (SP) and infrapatellar (IP) intramedullary nailing techniques in treating distal tibia fractures, utilizing data accrued from King George’s Medical University, Department of Orthopaedics, between Jan 2022 to August 2023.

Methods: A retrospective analysis was carried out involving two groups of patients who underwent either SP or IP nailing techniques. Several parameters including surgical time, blood loss, pain score and functional outcomes were evaluated. Functional outcomes were assessed on the basis of AOFAS scores.

Results: The SP group demonstrated a reduced mean surgical time (85.7±14.8 minutes) compared to the IP group (96.3±16.7 minutes, p=0.011). Moreover, the SP group reported lower pain scores (20.2±3.9) than the IP group (27.5±3.6, p<0.001) and exhibited better functional outcomes as evidenced by higher AOFAS scores (94.1±4.3 vs 88.5±4.7, p<0.001). However, no significant difference was noted in blood loss or fracture healing time between the two groups.

Conclusions: The study underscores the potential superiority of the suprapatellar approach in terms of reduced surgical time, lower pain scores and better functional outcomes. Despite this, the infrapatellar approach had a higher incidence of fracture deformities, necessitating a cautious approach when selecting surgical strategies. Further research with larger sample sizes is warranted to substantiate these preliminary findings.

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