Comparison of clinical effects of suprapatellar approach and infrapatellar approach for intramedullary nail fixation in the treatment of tibial shaft fracture
Objective To compare the clinical effects of suprapatellar approach and infrapatellar approach for intramedullary nail fixation in the treatment of tibial shaft fractures.Methods A total of 80 patients with tibial shaft fracture hospitalized in the No.1 extraosseous comprehensive department of Guizhou Hospital of Beijing Jishuitan Hospital from January 2022 to June 2023 were selected as the research objects,and the patients were divided into suprapatellar group and infrapatellar group according to the random number table method,with 40 cases in each group.The suprapatellar group was operated by suprapatellar approach,and the infrapatellar group was operated by infrapatellar approach.The operation time,hospitalization time,intraoperative blood loss,intraoperative fluoroscopy times,intraoperative secondary displacement,Hospital for Special Surgery Knee Score(HSS),modified Lysholm knee function score and complications were compared between the two groups.Results The operation time of the suprapatellar group was shorter than that of the infrapatellar group,and the difference was statistically significant(P<0.05).The intraoperative fluoroscopy times and intraoperative secondary displacement in the suprapatellar group were less than those in the infrapatellar group,and the differences were statistically significant(P<0.05).At 3 months after operation,the HSS and Lysholm scores of the two groups were higher than those before operation,the Lysholm score of the suprapatellar group was higher than that of the infrapatellar group,and the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of postoperative complications between the two groups(P>0.05).Conclusion Compared with the infrapatellar approach,the suprapatellar approach intramedullary nail fixation for the treatment of tibial shaft fracture has more advantages in operation time,intraoperative fluoroscopy times,intraoperative secondary displacement and knee joint function recovery.It is recommended that clinical decision makers give priority to the suprapatellar approach intramedullary nail fixation for the treatment of tibial shaft fracture.
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