Anterior Knee Pain after Tibial Intra-medullary Nailing: Is it Predictable?
- Author:
Soraganvi PC
;
Anand-Kumar BS
;
Rajagopalakrishnan R
;
Praveen-Kumar BA
- Publication Type:Journal Article
- Keywords:
Tibia nailing;
knee pain;
tibial articular cartilage patellar tendon;
intra medullary nail
- MeSH:
Tibial Fractures
- From:Malaysian Orthopaedic Journal
2016;10(2):16-20
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: Intramedullary nailing has been used
frequently for the treatment of tibial diaphyseal fractures.
Chronic anterior knee pain has been considered the most
frequent post-operative complication of this technique. We
investigated the relationship between anterior knee pain and
position of nail tip in proximal tibia.
Methods: 103 patients were selected among patients who
underwent interlocking nailing in our institution. Patients
with other factors that might cause anterior knee pain were
excluded. In all patients intramedullary nailing was done
using transpatellar approach. The patients were evaluated in
two groups, 42 patients had anterior knee pain (Group A),
whereas 61 patients did not have pain (Group B). The
distance from nail tip from tibial plateau was measured on
lateral radiographs. Nail prominence from anterior tibial
cortex was also measured.
Results: The two groups were similar with respect to gender
and follow up period. Out of 42 patients who had knee pain
21 (50%) had nail tip within proximal third distance from
plateau to tibial tuberosity. Twenty-four patients (42%)
among knee pain group had nail prominence of more than
5mm from anterior tibial cortex followed by 12 patients
(29%) within 5mm and 12 patients (29%) nail tip buried
within the anterior cortex.
Conclusion: A greater incidence of knee pain was found
when nail was prominent more than 5mm and when it is in
the proximal third distance from tibial plateau to tuberosity.
Patients should be aware of high incidence of knee pain
when the nail tip is placed in proximal third and prominence
of more than 5mm.
- Full text:P020160923501944887196.pdf
