Effect of Two Different Intramedullary Nailing Approaches on Fracture Healing,Knee Function,and Complications in Tibial Shaft Fractures
LUO Ming
LI Yan
DANGN Haifeng
ZHAO Yinan
FAN Junjun
CHANG Yukun
GAO Zilong
GAO Wucai
LU Lili
HAN Li
Abstract：Objective To analyze the effects of two different approaches for intramedullary nailing—the lateral parapatellar approach and the suprapatellar approach—on fracture healing,knee joint function,and complications in patients with tibial shaft fractures.Methods A retrospective analysis was conducted on 197 patients with tibial shaft fractures who underwent intramedullary nailing in the Department of Orthopedics,The First Affiliated Hospital of Air Force Medical University from January 2022 to November 2024.According to the surgical approach,patients were divided into Group A(lateral parapatellar approach,n=102)and Group B(suprapatellar approach,n=95).The following were compared between the two groups:clinical efficacy,surgical-related indicators,fracture healing status(fracture healing time,callus formation time),angulation deformity at the fracture site(coronal varus/valgus deformity,sagittal anterior/posterior angulation),knee joint function[Hospital for Special Surgery(HSS)knee score],and complications.Results At the 6-month follow-up,the excellent-good rate in Group A was 96.08%(98/102),significantly higher than 87.37%(83/95)in Group B(P<0.05).Group A had fewer intraoperative X-ray exposures than Group B(P<0.05).No significant differences were found in fracture healing time,callus formation time,incidence of fracture angulation deformity within 6 months,or total postoperative complication rate(P>0.05).At the 3-month follow-up,no significant difference existed in HSS scores between groups(P>0.05).At the 6-month follow-up,HSS scores increased in both groups compared to the 3-month assessment,with Group A scoring higher than Group B(P<0.05).Conclusion Compared with the suprapatellar approach,the lateral parapatellar approach for intramedullary nailing offers superior efficacy in treating tibial shaft fractures,reduces intraoperative X-ray exposures,and promotes knee function recovery.Nevertheless,attention should be paid to intraoperative mechanical axis control and minimizing impact on the patellofemoral joint.
Keywords：tibial fracturesfracture fixationintramedullarylateral parapatellar approachsuprapatellar approachfracture healing
Publication Date：2025-08-20
Online Publishing Date：2025-09-18(First online date of this platform, not the publication date of the document)
Pages：5( 42-46 )