Comparison of lateral parapatellar versus infrapatellar approaches for intramedullary nailing for tibial shaft fractures

Nie, Guanghua; Yang, Lifeng

doi:10.3389/fsurg.2025.1521860

ORIGINAL RESEARCH article

Front. Surg.

Sec. Orthopedic Surgery

Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1521860

This article is part of the Research Topic Surgical Advances in Orthopedic Trauma: A Biomechanical Approach View all 3 articles

Comparison of lateral parapatellar versus infrapatellar approaches for intramedullary nailing for tibial shaft fractures

Provisionally accepted

Guanghua Nie ^1*

Lifeng Yang ²

¹ Xi'an Jiaotong University, Xi'an, China
² Luonan County Hospital, Luonan, China

The final, formatted version of the article will be published soon.

Background:This study aimed to evaluate the clinical and functional outcomes of tibial shaft fractures treated with intramedullary nailing (IMN) using the lateral parapatellar entry (LPE) and infrapatellar (IP) surgical approaches.Methods: A total of 85 patients with tibial shaft fractures treated with IMN between January 2019 and December 2022 were retrospectively analyzed. A total of 40 and 45 patients underwent IMN using the LPE and IP surgical approaches, respectively. The operation time, intraoperative fluoroscopy times, blood loss, closed reduction rate, fracture healing time and complications were reviewed in this study. The American Orthopaedic Foot and Ankle Society (AOFAS) scale and Lysholm Knee Scoring Scale were used as functional measurements.Results: The study included 85 patients (40 in the LPE group and 45 in the IP group), with a minimum follow-up of 12 months. No significant differences were found in fracture healing time, closed reduction rate, infection, deformity healing rate, Lysholm scores, and AOFAS scores between the groups. The LPE group displayed an significantly shorter operation duration, less blood loss, fewer fluoroscopy times, and a lower average VAS score compared to the IP group (P < 0.05).Conclusions: The LPE approach for IMN in tibial shaft fractures may offer advantages in terms of fewer fluoroscopy times, and lower complication rates, suggesting it could be a preferable surgical approach.

Keywords: Tibial Shaft Fractures, lateral parapatellar entry, Infrapatellar, intramedullary nailing, Surgical approaches

Received: 07 Nov 2024; Accepted: 28 Mar 2025.

Copyright: © 2025 Nie and Yang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Guanghua Nie, Xi'an Jiaotong University, Xi'an, 710049, China

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