Retrospective cohort study from two level I trauma centers comparing immediate postoperative radiographic alignment in 266 patients with distal tibia fractures (within 5 cm of the plafond) treated with either suprapatellar or infrapatellar intramedullary nailing.
When nailing a distal tibia fracture within 5 cm of the plafond, consider the suprapatellar approach: keeping the leg semiextended lets you hold your reduction while you ream and pass the nail, rather than fighting the fracture every time you move the leg for a fluoro shot.
The infrapatellar malalignment rate of over 25% in this series is consistent with prior RCT data — the technique, not just the implant, drives that number.
Retrospective cohort study from two level I trauma centers comparing immediate postoperative radiographic alignment in 266 patients with distal tibia fractures (within 5 cm of the plafond) treated with either suprapatellar or infrapatellar intramedullary nailing.
When nailing a distal tibia fracture within 5 cm of the plafond, consider the suprapatellar approach: keeping the leg semiextended lets you hold your reduction while you ream and pass the nail, rather than fighting the fracture every time you move the leg for a fluoro shot.
The infrapatellar malalignment rate of over 25% in this series is consistent with prior RCT data — the technique, not just the implant, drives that number.