• Robinson Esteves Pires, Fernando Bidolegui, José Arturo Xicará, Marco Antonio Altamirano-Cruz, Guido Sebastián Carabelli, Carlos Oliver Valderrama-Molina, Amparo Gómez, Jorge Enrique Velarde, Matheus Lemos Azi, William Dias Belangero, and Vincenzo Giordano.
• Departamento do Aparelho Locomotor, Universidade Federal de Minas Gerais, Belo Horizonte (MG), Brazil. Electronic address: robinsonestevespires@gmail.com.
• Injury. 2023 Nov 1; 54 Suppl 6: 110774110774.

ObjectiveThe aim of this study was to evaluate the Latin American orthopaedic trauma surgeons preference regarding knee positioning and entry portals for IM nailing and identify the reasons of these preferences.MethodsUsing the AO Trauma database, 22.285 surveys were distributed by email to Latin American orthopaedic surgeons. Demographic data and practice patterns, especially regarding knee positioning and approach for tibial nailing, were then evaluated and statistically treated.Resultsamongst one thousand five hundred fourteen responses, 990 orthopaedic surgeons (4.4% of response rate) fully responded to the survey. Transpatellar tendon approach (613 / 61.9%,) with the knee in flexion (518 / 52.3%) on a radiolucent table remains the standard practice for intramedullary tibial nailing. Even for proximal and distal tibial nailing, the transpatellar tendon approach (455 / 46%) with the knee in flexion (562 / 56.8%) hold on the most used method. Only 55 (9.36%) orthopaedic surgeons reported that they have migrated to the supra-patellar tibial nailing in the recent years. The main reasons for a low rate of migration were lack of knowledge about the technique and unavailability of specific gigs and cartilage protectors for a safe suprapatellar nailing.ConclusionEven with the potential benefits of the semi-extended knee positioning for tibial nailing, the Latin American orthopaedic community remains using the transpatellar tendon approach with the knee in flexion as the standard technique. Lack of surgical training for suprapatellar and parapatellar approaches with the knee in semi-extension, added by the unavailability of suprapatellar jigs and soft outer protection sleeves contribute to counter the trend towards the semi-extended techniques.Copyright © 2023 Elsevier Ltd. All rights reserved.

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