LOCALIZATION OF THE TIBIAL ENTRY POINT

Area of Science:

• Orthopedic surgery
• Traumatology
• Biomedical engineering

Background:

• Intramedullary nail fixation is a standard treatment for tibial fractures.
• The choice of entry point for tibial intramedullary nailing can influence surgical outcomes and patient recovery.
• Understanding patient and surgeon preferences for nail entry points is crucial for optimizing treatment strategies.

Purpose of the Study:

• To evaluate preferred intramedullary nail entry points in the proximal tibia.
• To correlate patient and surgeon reasons for choosing specific entry points with radiographic views.
• To identify factors influencing the selection of tibial nail entry approaches.

Main Methods:

• A questionnaire-based study involving 230 participants with tibial fractures.
• The questionnaire included yes/no questions and image-based selections (anteroposterior and lateral views).
• Analysis of reasons for access choice, including ease of access, nail insertion, knee pain prevention, tendinitis avoidance, and valgus deformity prevention.

Main Results:

• Transpatellar access was the most frequently chosen approach (66.5%).
• Primary reasons for access choice included ease of access (67.8%) and better nail insertion (60.9%).
• Preventing knee pain and avoiding tendinitis were significantly associated with specific radiographic points (medial tibial crest).

Conclusions:

• Patient-reported functional reasons favored medial parapatellar access, while practical medical reasons supported transpatellar ligament access.
• Increasing age correlated with a higher preference for avoiding valgus deformity.
• Transpatellar access remains the predominant choice among participants for tibial intramedullary nailing.