Zentralbl Chir 2011; 136 - V_43
DOI: 10.1055/s-0031-1289008

Anterior knee pain after T2 intramedullary nailing of tibial fracture: An international multicenter prospective clinical study

R Jairam 1, 2, JP Stahl 1, P de Lucas 3, K Westermann 4
  • 1Klinikum Dortmund, Klinikzentrum Nord/Unfallklinik, Dortmund, Germany
  • 2Vrije Universiteit Medisch Centrum Amsterdam, Department of General and Trauma-Surgery, Amsterdam, Netherlands
  • 3Hospital Universitario Ramn y Cajal Madrid, Department of Othopaedic and Trauma-Surgery, Madrid, Spain
  • 4Klinikum Nordstadt, Unfallklinik, Hannover, Germany

Introduction: Anterior knee pain is one of the most frequent complications of tibial nailing. Its aetiology remains unclear, potentially being a multifactorial event. The aim of this prospective study was to evaluate if anterior knee pain has any negative influence on: bone healing (the hypothesis is if the patient has anterior knee pain he or she will not put weight on the affected leg and this will not stimulate the bone healing), ability to return to work and quality of live.

Materials and methods: 3 European level 1 trauma centers were involved in this study.

Between January 2003 and December 2004, 102 patients were included (inclusion and exclusion criteria) in this study. We used a standard T2 tibia nail (stryker) with the possibility of proximal and distal fixation with 3 screws. The approach was trans or parapatellar. The follow up periods were after 4–6 weeks, 4 months and 12 months.

Results: At 4–6 weeks, 4 months, 12 months follow-up we had 11, 13, 14 patients with anterior knee pain. The VAS for pain decreased from 3.1 to 2.3. Bone healing was 100% and for 70% of patients it was possible to do their previous fulltime job after 12 months. The quality of life (walking up and down the stairs normally without any help, putting on socks and shoes, sitting/standing from a chair, total weight bearing) was improving.

Conclusions: We conclude that anterior knee pain in this study was mild, the two different method of patellar tendon approach (trans/paratendinous) have no relevance and it does not have a negative influence on bone healing, ability to return to work and the quality of life.

References:

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