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Archives of Orthopaedic and Trauma Surgery
Published in: Archives of Orthopaedic and Trauma Surgery 2/2024

30-11-2023 | Tibial Plateau Fracture | Orthopaedic Surgery

Suprapatellar intramedullary nail combined with screw fixation has comparable surgical outcomes to minimally invasive locking plate fixation in ipsilateral tibial plateau and shaft fractures

Authors: Sumin Lim, Hyung Keun Song, Tae Hun Kim, Do Young Park, Jong Wha Lee, Jun Young Chung

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 2/2024

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Abstract

Purpose

To compare union rate, union time, alignment, and complication rate in ipsilateral tibia plateau and shaft fractures treated via suprapatellar intramedullary nailing with screw fixation and minimally invasive locking plate fixation.

Materials and methods

A retrospective study was conducted on 48 patients who underwent minimally invasive plate fixation (n = 35) or suprapatellar intramedullary nailing with screw fixation (n = 13), for the treatment of ipsilateral tibial plateau and shaft fractures with at least 1-year follow-up. Union rate, union time, radiologic alignment, and complication rate such as malalignment, nonunion, and fracture-related infection (FRI) were investigated.

Results

Demographic data were not different between the two groups. Coronal plane alignment was 0.17 ± 4.23 in the plate group and −0.48 ± 4.17 in the intramedullary nail group (p = 0.637). Sagittal plane alignment was −0.13 ± 5.20 in the plate group and −1.50 ± 4.01 in the suprapatellar intramedullary nail group (p = 0.313). Coronal and sagittal malalignment recorded equal results: (p > 0.99), FRI (p = 0.602), nonunion and union times recorded (p = 0.656) and (p = 0.683, 0.829), respectively, and showed no significant difference between the two groups.

Conclusion

Suprapatellar intramedullary nailing with screw fixation had similar surgical outcomes with minimally invasive locking plate fixation in ipsilateral tibial plateau and shaft fractures in terms of union rate, union time, alignment, and complication rate. Thus, frequent use of intramedullary nailing combined with screw fixation is anticipated in patients with ipsilateral tibial plateau and shaft fractures when the soft tissue condition is not desirable.

Level of evidence

Level III
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Metadata
Title
Suprapatellar intramedullary nail combined with screw fixation has comparable surgical outcomes to minimally invasive locking plate fixation in ipsilateral tibial plateau and shaft fractures
Authors
Sumin Lim
Hyung Keun Song
Tae Hun Kim
Do Young Park
Jong Wha Lee
Jun Young Chung
Publication date
30-11-2023
Publisher
Springer Berlin Heidelberg
Published in
Archives of Orthopaedic and Trauma Surgery / Issue 2/2024
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-023-05147-8

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