• Tomohiro Yasuda, Kaoru Sato, Ken Yamazaki, Masayuki Arai, Daichi Shinohara, Yoneya Taisuke, Yuuto Minagawa, Yuki Samejima, Keiji Okamoto, Yuko Irie, Kyosuke Shiobara, Atsushi Kusaba, Keikichi Kawasaki, Junji Hayashi, Shu Obara, Koji Kanzaki, and Katsunori Inagaki.
• Department of Orthopedic Surgery, Showa University Fujigaoka Hospital, Yokohama, Japan.
• Injury. 2022 Oct 1; 53 (10): 3508-3516.

IntroductionSemi-extended tibial nailing techniques include the extra-articular technique (EAT) and the patellar eversion technique (PET). These approaches differ regarding the exposure of the patellar retinaculum and the size of the surgical field. This study compared the postoperative alignment and intramedullary nailing entry points between the EAT and PET for tibial fractures.Patients And MethodsA total of 54 patients (aged ≥18 years) who had undergone intramedullary nailing by the EAT (n = 29) or PET (n = 25) for a tibial shaft fracture were evaluated. The intramedullary nailing entry point and postoperative alignment were measured, and the 1-year postoperative follow-up results were compared.ResultsFor the EAT and PET, the intramedullary nailing entry point was located at a mean distance of 4.04 mm medial to the optimal entry point and 0.27 mm lateral to the optimal entry point, respectively. The mean angular deformation observed in anteroposterior radiographs following surgery using the EAT and PET were 2.49° and 0.32° valgus, respectively.ConclusionThe intramedullary nailing entry point affected postoperative alignment. Intramedullary nailing may result in malalignment while performing the EAT due to the interference of the patella at the time of nailing.Copyright © 2022. Published by Elsevier Ltd.

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