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Updated: Mar 23, 2026
Treatment with Locking Intramedullary Nailing for Intertrochanteric Fracture of the Femur Utilizing a New Awl with a Distal Positioner
Published on: June 6, 2025
ANATOMICAL STUDY ON THE LATERAL SUPRAPATELLAR ACCESS ROUTE FOR LOCKED INTRAMEDULLARY NAILS IN TIBIAL FRACTURES
Italo Scanavini Cerqueira1, Pedro Araujo Petersen1, Rames Mattar Júnior2
1Resident in Orthopedics and Traumatology, Institute of Orthopedics and Traumatology, HC-FMUSP, São Paulo, SP, Brazil.
Objective:
Intramedullary nails are the gold standard for treating tibial shaft fractures. Knee pain is a frequent complication after the procedure. Alternative routes such as the suprapatellar approach for nail insertion are seen as an option for avoiding late postoperative knee pain. The question is whether this approach might give rise to any injury to intra-articular structures of the knee.
Methods:
This study analyzed the suprapatellar approach and the risk to adjacent structures by reproducing it in 10 knees of five cadavers.
Results:
This approach was seen to make it easy to locate the entry point, with lesions only occurring in the Hoffa fat. In three of our cases, there were lesions of the chondral surface, which is an obstacle that is difficult to overcome.
Conclusion:
There is a need to develop specific material to minimize injury to intra-articular structures when using this route.
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