Semiextended approach for intramedullary nailing via a patellar eversion technique for tibial-shaft fractures: Evaluation of the patellofemoral joint |
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| Affiliation: | 1. Department of Orthopedic Surgery, National Medical Center, Seoul, Republic of Korea;2. Department of Orthopedic Surgery, Ewha Womans University, College of Medicine, Seoul, Republic of Korea;1. School of Medicine, University of Pretoria, South Africa;2. Valiant Clinic/Houston Methodist Group, Dubai, United Arab Emirates;3. Walk-a-Mile Centre for Advanced Orthopaedics, Pretoria, South Africa;4. Department of Orthopaedic Surgery, University of Pretoria, Steve Biko Academic Hospital, South Africa;5. Department of Orthopaedic Surgery, University of Texas Health Science Center, San Antonio, TX, USA;6. Department of Orthopaedic Surgery, Royal Brisbane Hospital, Herston, Australia;7. Department of Surgery, School of Medicine, University of Queensland, Australia;8. Queensland University of Technology, Orthopaedic Research Institute, Australia;1. Siheung 21C Hospital, Republic of Korea;2. Department of Orthopaedics, Ajou University School of Medicine, Republic of Korea;1. University of Queensland, School of Medicine, Herston, Brisbane, Australia;2. Ipswich General Hospital, Chelmsford Ave, Ipswich, Queensland, Australia;1. Harvard Combined Orthopaedic Surgery Residency Program, Boston, MA, United States;2. Center for Advanced Orthopaedic Studies at Beth Israel Deaconess Medical Center - Harvard Medical School, Boston, MA, United States;3. Beth Israel Deaconess Medical Center, Boston, MA, United States;4. The Commonwealth Medical College, Scranton, PA, United States |
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| Abstract: | Intramedullary nail fixation is a common treatment for tibial-shaft fractures, and it offers a better functional prognosis than other conservative treatments. Currently, the primary approach employed during intramedullary nail insertion is the semiextended position is the suprapatellar approach, which involves a vertical incision of the quadriceps tendon Damage to the patellofemoral joint cartilage has been highlighted as a drawback associated with this approach. To avoid this issue, we perform surgery using the patellar eversion technique and a soft sleeve. This method allows the articular surface to be monitored during intramedullary nail insertion. We arthroscopically assessed the effect of this technique on patellofemoral joint cartilage. The patellar eversion technique allows a direct view and protection of the patellofemoral joint without affecting the patella. Thus, damage to the patellofemoral joint cartilage can be avoided. |
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| Keywords: | Patellar eversion technique Semiextended approach Tibial intramedullary nail Tibia fractures Technique Soft sleeve |
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