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ORIGINAL ARTICLE
Year : 2018  |  Volume : 10  |  Issue : 2  |  Page : 120-123

Evaluation of chronic anterior knee pain following interlocking nailing of diaphyseal fractures of tibia


1 Department of Orthopaedics, GMCH, Balasore, Odisha, India
2 Department of Orthopaedics, SCB Medical College, Cuttack, Odisha, India

Correspondence Address:
Dr. Udit Saurav Sahoo
Department of Orthopaedics, SCB Medical College, Cuttack, Odisha
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jotr.jotr_18_18

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Background: Chronic Anterior Knee pain is the most common post-operative complication following Intramedullary interlocking nailing of Tibial shaft fractures. Its incidence has been reported to range between 10 % to 86% but no definite cause can be attributed. This study was conducted to analyse the prevalence & severity of anterior knee pain in post tibial nailing patients with relation to nail protrusion, approach and proximal screw size. Methods and Material: 92 consecutive patients with an isolated tibia shaft fracture; treated with reamed IMIL nailing from 2014 to 2016 were included in the study. Chronic Anterior knee pain was assessed as per VAS. Besides X-ray, Ultrasound evaluation of patellar tendon morphology and nail protrusion was done. Statistical analysis used: student t test. Chi square test. Results: In the symptomatic group (28), 25patients (89%) had nail protrusion and only 3 patients (11%) did not have nail protrusion beyond proximal tibia cortical bone. In asymptomatic group, 20(33%) patients had nail protrusion and 40(67%) patients did not have nail protrusion. This difference was statistically significant with P value 0.00. In symptomatic group, 11(39%) patients had larger screws and 17(61%) patients had normal length screws. In asymptomatic group, 41(68%) patients had normal length and 19(32%) had large screw. P value came out to be 0.48. Conclusions: Anterior knee pain may be related to protrusion of nail beyond proximal tibial cortical bone [p value 0.01], and larger proximal screw length [p value 0.08].


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