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Comparison of trans patellar approach and medial parapatellar tendon approach in tibial intramedullary nailing for treatment of tibial fractures.

OBJECTIVES
To evaluate the post-operative complications of intramedullary nailing technique by transpatellar approach compared to medial parapatellar approach.


METHODS
Fifty patients with tibial fractures treated by intramedullary nailing through two transpatellar (t-group) and medial parapatellar (p-group) approaches were studied. Knee pain was assessed with visual analogue scale (VAS) for 2 weeks, 1, 3 and 6 months and range of motion (ROM) in 2 weeks and 3 months after surgery.


RESULTS
There were 23 males and 2 females with a mean age of 28.68 +/- 5.78 years in t-group and 21 males and 4 females with a mean age of 28.80 +/- 5.82 in p-group. There was significant difference in knee pain score after 3 months (p = 0.013) and 6 months (p = 0.009) between the two study groups (p-group had less pain than t-group). But there was not significant difference between the two study groups in range of motion after 2 weeks and 3 months of surgery.


CONCLUSION
Our study recommends medial parapatellar tendon approach, although both approaches are safe.