Knee Pain after Tibial Nailing

J. F. Keating, Robert Orfaly, P. J. O'Brien

Research output: Contribution to journalArticle

148 Citations (Scopus)

Abstract

Objective: To determine the incidence and natural history of knee pain following tibial nailing. Design: A retrospective analysis of patients treated by tibial nailing evaluating a consecutive series of patients with isolated tibial shaft fractures. Setting: A level one trauma center in Vancouver, British Columbia. Patients: A group of 107 consecutive patients with 110 tibial fractures treated by interlocking tibial nailing. Intervention: Patients were contacted and interviewed by the authors. Clinical records and radiographs were analysed. Main Outcome Measurements: Incidence of knee pain; time of onset; relationship of nail position on radiographs to knee pain; relationship of knee pain to site of nail insertion; response to nail removal. Results: At a mean follow-up period of thirty-two months (12-58 months), sixty-one (57%) patients (63 of 110 knees) had developed anterior knee pain. There was no correlation between nail protrusion and knee pain. Insertion of the nail through the patella tendon was associated with a higher incidence of knee pain compared to the paratendon site of nail insertion (77% and 50% respectively). Of patients with knee pain, 80% (49/61) required nail removal. At a mean duration of 16 months following nail removal, pain was completely relieved in 22 patients and partially relieved in 17. In the remaining 10 patients, there was no improvement. Conclusions: Based on this data, we would recommend a parapatellar tendon incision for nail insertion, and nail removal for those patients with a painful knee. The causes of knee pain after tibial nailing are multi-factorial and require further study.

Original languageEnglish (US)
Pages (from-to)10-13
Number of pages4
JournalJournal of Orthopaedic Trauma
Volume11
Issue number1
StatePublished - Jan 1997
Externally publishedYes

Fingerprint

Nails
Knee
Pain
Tibial Fractures
Incidence
Patellar Ligament
British Columbia
Trauma Centers
Natural History
Tendons

Keywords

  • Intramedullary nailing
  • Knee pain
  • Tibial shaft fracture

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Surgery
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

Keating, J. F., Orfaly, R., & O'Brien, P. J. (1997). Knee Pain after Tibial Nailing. Journal of Orthopaedic Trauma, 11(1), 10-13.

Knee Pain after Tibial Nailing. / Keating, J. F.; Orfaly, Robert; O'Brien, P. J.

In: Journal of Orthopaedic Trauma, Vol. 11, No. 1, 01.1997, p. 10-13.

Research output: Contribution to journalArticle

Keating, JF, Orfaly, R & O'Brien, PJ 1997, 'Knee Pain after Tibial Nailing', Journal of Orthopaedic Trauma, vol. 11, no. 1, pp. 10-13.
Keating JF, Orfaly R, O'Brien PJ. Knee Pain after Tibial Nailing. Journal of Orthopaedic Trauma. 1997 Jan;11(1):10-13.
Keating, J. F. ; Orfaly, Robert ; O'Brien, P. J. / Knee Pain after Tibial Nailing. In: Journal of Orthopaedic Trauma. 1997 ; Vol. 11, No. 1. pp. 10-13.
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