Use of the suprapatellar approach in intramedullary nailing of a multi-fragmentary dislocated tibia fracture with a hypermobile intermediate fragment in a young patient

  • Patrick Haubruck | patrick.haubruck@med.uni-heidelberg.de Heidelberg Trauma Research Group, Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Trauma and Reconstructive Surgery, Heidelberg University Hospital, Germany. http://orcid.org/0000-0002-7045-0387
  • Ulf Brunnemer Heidelberg Trauma Research Group, Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Trauma and Reconstructive Surgery, Heidelberg University Hospital, Germany.
  • Arash Moghaddam Heidelberg Trauma Research Group, Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Trauma and Reconstructive Surgery, Heidelberg University Hospital, Germany.
  • Gerhard Schmidmaier Heidelberg Trauma Research Group, Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Trauma and Reconstructive Surgery, Heidelberg University Hospital, Germany.

Abstract

A case of an adolescent female patient who suffered from first grade open multi-fragment fracture of the tibia (AO42-C2) with a large hypermobile intermediate fragment is presented in this case report. Intramedullary nailing of the tibia remains the treatment of choice despite a high risk of malformation and anterior knee pain especially in multi-fragment fractures. Here the suprapatellar approach as a semiextended nailing technique seems favorable. The specialty in our case was an early change of procedures necessary due to persistent swelling during external fixation based on the hypermobile intermediate fragment. Decision in favor of this surgical technique was conducted in order to achieve beneficial alignment and union while protecting the softtissue despite the hypermobile intermediate fragment and decrease the risk of anterior knee pain. In our case we achieved successful alignment and proper bone healing without any signs of anterior knee pain or limitations in the range of motion of the knee. With this report we would like to recommend the suprapatellar approach as a favorable alternative in intramedullary nailing in this type of fracture also in young patients.

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Published
2017-01-04
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Section
Brief Reports
Keywords:
supra patellar approach, intramedullary nailing, tibia fractures, patellofemoral joint
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How to Cite
Haubruck, P., Brunnemer, U., Moghaddam, A., & Schmidmaier, G. (2017). Use of the suprapatellar approach in intramedullary nailing of a multi-fragmentary dislocated tibia fracture with a hypermobile intermediate fragment in a young patient. Orthopedic Reviews, 8(4). https://doi.org/10.4081/or.2016.6738