Difference in Pain, Complication Rates, and Clinical Outcomes After Suprapatellar Versus Infrapatellar Nailing for Tibia Fractures? A Systematic Review of 1447 Patients

Objectives: To assess the effectiveness of suprapatellar (SP)-nailing versus infrapatellar (IP)-nailing tibia fractures in anterior knee pain, complications (retropatellar chondropathy, infection, and malalignment) physical functioning quality life. A clinical question-driven thorough systematic review current literature is provided. Data source: PubMed Embase databases were searched for studies published between 2010 2020 relating to SP IP-nailing fractures. The study performed concordance with PRISMA-guidelines. Study selection: Studies eligible inclusion randomized controlled trials, prospective retrospective observational reporting on outcomes interest. extraction: extraction was independently by 2 assessors. Methodological risk bias assessed according guidelines McMaster Critical Appraisal. synthesis: Continuous variables are presented as means SD dichotomous frequency percentages. weighted mean, standardized mean differences, 95% confidence interval calculated. pooled analysis could not be because differences outcome measures, time-points, heterogeneity. Results: Fourteen 1447 patients analyzed. incidence pain 29% after SP-nailing 39% IP-nailing, without reported significance. There a significant lower rate malalignment SP-approach (4% vs. 26%) small absolute all planes. No substantial observed retropatellar functioning, Conclusions: This does reveal superiority either technique any respective Definitive choice should depend surgeon's experience available resources. Level Evidence: Therapeutic II. See Instructions Authors complete description levels evidence.