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Related Concept Videos

Bones of the Lower Limb: Femur and Patella01:16

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The femur is the body's longest and strongest bone spanning the thigh region. Its head articulates with the acetabulum of the hip bone to form the hip joint. A minor indentation on the medial side of the femoral head, called the fovea capitis, serves as the site of attachment for the ligament of the head of the femur. This weak ligament spans the femur and acetabulum and supports the hip joint. The narrowed region below the head is the neck of the femur. The inclination angle between the...
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Related Experiment Video

Updated: Sep 22, 2025

Treatment with Locking Intramedullary Nailing for Intertrochanteric Fracture of the Femur Utilizing a New Awl with a Distal Positioner
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Suprapatellar tibial nailing, why have we changed?

P Rodríguez-Zamorano1, J García-Coiradas1, M Galán-Olleros1

  • 1Departamento de Cirugía Ortopédica y Traumatología, Hospital Clínico San Carlos, Madrid, España.

Revista Espanola De Cirugia Ortopedica Y Traumatologia
|May 19, 2022
PubMed
Summary
This summary is machine-generated.

The suprapatellar (SP) approach for tibial fractures offers improved functional outcomes, specifically higher IKDC scores, compared to the traditional infrapatellar (IP) method. This study found SP nailing to be a viable alternative without increasing complications.

Keywords:
Calidad de vidaDolor femoropatelarEnclavado endomedularFracturas de tibiaIntramedullary fracture fixationPatellofemoral painQuality of lifeResultados de tratamientoTibial fracturesTreatment outcome

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Area of Science:

  • Orthopedic surgery
  • Trauma management
  • Biomechanical analysis

Background:

  • Infrapatellar (IP) endomedullary nailing is standard for tibial diaphyseal fractures but linked to reduction challenges and complications like procurvatum malalignment and anterior knee pain.
  • The suprapatellar (SP) approach offers an alternative, potentially reducing operative time, radiation exposure, and improving surgical ease.

Purpose of the Study:

  • To compare the clinical, radiological, and functional outcomes of suprapatellar (SP) versus infrapatellar (IP) endomedullary nailing for tibial diaphyseal fractures.
  • To evaluate surgeon-perceived technical ease and intraoperative imaging quality between the two approaches.

Main Methods:

  • A retrospective comparative study involving 22 fractures treated with SP approach and 30 with IP transtendinous approach.
  • Analysis of perioperative variables, clinical, radiological, and functional outcomes at 3, 6, and 12 months post-surgery.

Main Results:

  • No significant differences were observed in intraoperative time, blood loss, reduction quality, or overall complications between SP and IP groups.
  • Anterior knee pain at 12 months was similar (54.5% SP vs. 53.3% IP).
  • The SP group demonstrated significantly better International Knee Documentation Committee (IKDC) scores (88.45 vs. 69, p=.006) compared to the IP group, with no differences in other functional scales.

Conclusions:

  • The suprapatellar (SP) nailing technique shows a trend towards improved medium-term functional results (IKDC scores) compared to the traditional infrapatellar (IP) method for tibial fractures.
  • The SP approach does not appear to increase complications and is perceived by surgeons as technically easier with simpler intraoperative imaging.
  • SP nailing represents a promising alternative for tibial fracture treatment, enhancing patient outcomes and surgical efficiency.