Knee Pain Clinical Trial
Official title:
Nail Position Has an Influence on Anterior Knee Pain After Tibial Intramedullary Nailing
Anterior knee pain (AKP) is a common complication following intramedullary (IM) nailing of a tibial shaft fracture. The purpose of this prospective study was to determine if there is an association between AKP and nail position. The investigators have analyzed postoperative outcome results and the possible relationship between AKP according to the visual-analog scale (VAS) scale, and nail position marked as a distance from the tip of the nail to the tibial plateau (NP) and tuberositas tibiae (NT), measured postoperatively on L-L knee X-rays.
The aim of this study was to determine the possible relationship between anterior knee pain
(AKP) and nail position marked as a distance from tip of nail to tibial plateau (NP) and to
the tuberositas tibiae (NT).
We evaluated postoperative outcome results of 50 patients in the last 3 years with healed
fractures initially treated with intramedullary (IM) reamed nails with 2 or 3 interlocking
screws on both parts of the nail and with the use of medial peritendinous incision for nail
entry portal. Patients marked a point on the visual analog scale (VAS) that corresponded to
the level of postoperative AKP felt. Two groups of patients were formed on the basis of AKP
(pain level was neglected): groups A and B, with and without pain, respectively.
We found that the difference between the two groups concerning NP measurements was
statistically significant, but not concerning NT measurements (P < 0.05). Patients were
classified by pain with high accuracy (98%) according to a classification tree.
We conclude that the symptoms of AKP did not appear if the tip of the nail position was more
than 6.0 mm from the NP and more than 2.6 mm from the NT. However, for better evaluation of
these results it will be necessary to examine more postoperative patients with AKP.
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Observational Model: Cohort, Time Perspective: Prospective
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