Suprapatellar approach for intramedulary tibial nailing in semi extended position of knee joint: Case series study

Sudhakar, R (2018) Suprapatellar approach for intramedulary tibial nailing in semi extended position of knee joint: Case series study. Masters thesis, Madras Medical College, Chennai.

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Abstract

INTRODUCTION: Fractures of tibia and fibula shaft are the most common long bone fractures. In an average population more than 45 both bone leg fractures per one lakh population per year. Tibial fractures are associated with wide range of injury mechanism and severity. The highest incidence of adult both bone leg fractures seen in young males is between 19 and 39 years of age.Compared to fractures elsewhere in the body, tibial fracture has relatively high incidence of nonunion and malunion. Tibial diaphysis is the most common site of fracture in the tibia and about 80% of these injuries are associated with fibular fractures. Various treatment options are available for tibial shaft fractures dependimg upon the associated soft tissue injury. Severe open fractures of tibia are associated with high complication rates and poor long term outcomes. It is typically encountered in young patients and are a result of high energy trauma. In surgical treatment intramedullary nail fixation remains the treatment of choice for displaced and undisplaced tibial shaft fractures in adult population. AIM OF THE STUDY: The aim is to study the clinical, radiological and functional outcome and complication for tibial shaft fractures treated with intramedullary nailing through suprapatellar approach in semi extended position of knee at the Institute of orthopedics and traumatology ,Madras Medical College , Rajiv Gandhi Government General Hospital, Chennai, during the period of year October 2015 to October 2017. MATERIALS AND METHODS: This is a prospective study for the study of the clinical, radiological and functional outcome and complication for tibial shaft fractures treated with intramedullary nailing through suprapatellar approach in semi extended position of knee in 20 patients in the period of October 2015 to October 2017 at Our Institute of Orthopaedics and Traumatology, Madras medical college and Rajiv Gandhi Government general hospital, Chennai. CONCLUSION: Reamed locked intramedullary nailing remains the standard treatment for displaced tibial shaft fractures. In our study we describe surgical hints in addition to the benefits of suprapatellar approach.A correct starting point remains a crucial part of surgical procedure.Suprapatellar approach of intramedullary tibial nailing in semi extended position of knee offers an alternative to traditional infrapatellar approach.Specific instrumentation with a canula system allows for nail insertion in a safe fashion and minimize the risk of iatrogenic damage to intraarticular structures. The semiextended position of knee facilitate fracture reduction particular in proximal third tibial fracture and all diaphyseal tibial fractures. This approach had excellent outcome for Ipsilateral Femoral Shaft Fractures, Stiff Knee and Proximal 1/3rd of Tibia Fracture. The preliminary data suggested a low rate of post operative anterior knee pain.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Suprapatellar approach ; intramedulary tibial nailing ; semi extended position ; knee joint ; Case series study.
Subjects: MEDICAL > Orthopaedics
Depositing User: Subramani R
Date Deposited: 14 Jul 2018 01:11
Last Modified: 14 Jul 2018 01:11
URI: http://repository-tnmgrmu.ac.in/id/eprint/8740

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