Is there a trend towards semi-extended knee positioning during intramedullary tibial nailing in Latin America? A survey among 990 orthopaedic surgeons.

Autor: Pires RE; Departamento do Aparelho Locomotor, Universidade Federal de Minas Gerais, Belo Horizonte (MG), Brazil. Electronic address: robinsonestevespires@gmail.com., Bidolegui F; Servicio de Ortopedia y Traumatología, Hospital Sirio Libanés, Buenos Aires (BA), Argentina., Xicará JA; Servicio de Ortopedia y Traumatología, Universidad San Carlos, Quetzaltenango, Guatemala., Altamirano-Cruz MA; Centro Médico Nacional de Occidente IMSS, Mexico., Carabelli GS; Hospital Italiano de Buenos Aires, Argentina., Valderrama-Molina CO; Hospital Pablo Tobón Uribe, Colombia., Gómez A; Hospital Universitario de la Samaritana, Colombia., Velarde JE; Centro Ortopédico Nacional, Panama., Azi ML; Hospital Manoel Victorino, Brazil., Belangero WD; Universidade Estadual de Campinas UNICAMP, Brazil., Giordano V; Serviço de Ortopedia e Traumatologia Professor Nova Monteiro, Hospital Municipal Miguel Couto, Rio de Janeiro (RJ), Brazil.
Jazyk: angličtina
Zdroj: Injury [Injury] 2023 Nov; Vol. 54 Suppl 6, pp. 110774.
DOI: 10.1016/j.injury.2023.05.005
Abstrakt: Objective: The 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.
Methods: Using 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.
Results: amongst 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.
Conclusion: Even 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.
Competing Interests: Declaration of Competing Interest The authors of the study “Is there a trend towards semi-extended knee positioning during intramedullary tibial nailing in Latin America? A survey amongst 990 orthopaedic surgeons” declare that they have no conflict of interest related to this manuscript.
(Copyright © 2023 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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