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ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2023

Comparison between functionality and quality of reduction between suprapatellar vs infrapatellar approaches in the treatment of diaphyseal and distal tibial fractures.

Lionel Llano, Maria Liliana Soruco, Danilo Taype Zamboni, Carlos Sancineto, Jorge Barla, Guido Carabelli

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Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. A systematic review and meta-analysis comparing suprapatellar versus infrapatellar approach intramedullary nailing for tibal shaft fractures.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024
    Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Lionel LlanoTrauma Section, Instituto de Ortopedia y Traumatología "Carlos E. Ottolenghi" Hospital Italiano de, Tte. Gral. Juan D. Perón, 4190 C1199ABB, Buenos Aires, Argentina. lionel.llano@hospitalitaliano.org.ar.
Maria Liliana SorucoTrauma Section, Instituto de Ortopedia y Traumatología "Carlos E. Ottolenghi" Hospital Italiano de, Tte. Gral. Juan D. Perón, 4190 C1199ABB, Buenos Aires, Argentina.
Danilo Taype ZamboniTrauma Section, Instituto de Ortopedia y Traumatología "Carlos E. Ottolenghi" Hospital Italiano de, Tte. Gral. Juan D. Perón, 4190 C1199ABB, Buenos Aires, Argentina.
Carlos SancinetoTrauma Section, Instituto de Ortopedia y Traumatología "Carlos E. Ottolenghi" Hospital Italiano de, Tte. Gral. Juan D. Perón, 4190 C1199ABB, Buenos Aires, Argentina.
Jorge BarlaTrauma Section, Instituto de Ortopedia y Traumatología "Carlos E. Ottolenghi" Hospital Italiano de, Tte. Gral. Juan D. Perón, 4190 C1199ABB, Buenos Aires, Argentina.
Guido CarabelliTrauma Section, Instituto de Ortopedia y Traumatología "Carlos E. Ottolenghi" Hospital Italiano de, Tte. Gral. Juan D. Perón, 4190 C1199ABB, Buenos Aires, Argentina.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionIntramedullary nailing is the most frequent procedure used for the treatment of tibial fractures that do not involve the articular surfaces. The goal of this study is to analyse the clinical outcomes, time of surgery and use of fluoroscopy in patients with midshaft and distal tibial fractures treated with suprapatellar and infrapatellar nailing and compare the results between these different groups.

methodsA retrospective study was conducted, and patients were selected between the period of March 2018 and October 2019. The following variables were studied: age, gender, AO classification, time of surgery (minutes), time of fluoroscopy (seconds), quality of reduction in postoperative controls and 1 year follow-up (using the angles MPTA, LDTA, PPTA, ADTA). Functional outcomes were studied at 1 month and 1 year follow-up. The visual analogue scale was used to study and compare the postoperative pain of the patients. The Lysholm Knee Score was used to evaluate the functional outcomes of the patients.

resultsA total of 80 patients meeting the inclusion criteria were included in this study. The suprapatellar approach was used in 44 patients and the infrapatellar in 36 patients. The time of surgery (p=0.008) and the mean time of use of fluoroscopy (p <0.001) difference were significant in favour of the suprapatellar approach. In the quality of reduction analysis, we have statistically significant results in the LDTA and ADTA angles. Also, in the evaluation of postoperative pain, significant difference was found in favour of the suprapatellar approach.

conclusionIn conclusion, our study compared the suprapatellar approach and the infrapatellar approach for the treatment of midshaft and distal tibia fractures with intramedullary nailing. The results showed lesser time of surgery and use of fluoroscopy, lower knee pain, and lower rate of malalignment with the suprapatellar approach than with the infrapatellar approach.

Indexed as

Fracture Fixation, IntramedullaryTibial FracturesBone NailsDiterpenesHumansPatellaPostoperative PainRetrospective StudiesTreatment Outcome3-acetoxy-1,11,12-dolabell-4,8,18-trien-16-alDiterpenesInfrapatellar approachSuprapatellar approachTibial fractures

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.