Functional Knee Outcomes in Suprapatellar and Infrapatellar Tibial Nailing: Does Approach Matter?

Introduction With an incidence of 75,000 per year in the United States alone, fractures of the tibial shaft are among the most common long bone fractures. Techniques using a semi-extended suprapatellar approach can facilitate intraoperative imaging, allow easier access to starting site position and counter deforming forces. While outcomes following traditional infrapatellar nailing have been well documented, there is a paucity of literature regarding outcomes following the use of a suprapatellar approach. By splitting the quadriceps tendon, scar tissue will form superior to the patella as opposed to the anterior knee, which may reduce flexion-related pain or pain while kneeling. The infrapatellar nerve is also well protected during this approach. The purpose of this study was to determine differences in functional knee pain in patients who underwent suprapatellar nailing versus traditional infrapatellar nailing.