Research Journal of Medical Sciences
ISSN: Online 1993-6095ISSN: Print 1815-9346
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Abstract
Tibial shaft fractures are among the most common long bone fractures, often associated with high‐energy trauma and complications such as acute compartment syndrome (ACS). Intramedullary nailing (IMN) is the gold standard for treating these fractures, performed using either the infrapatellar (IP) or suprapatellar (SP) approach. While the IP approach is traditional, its positioning has been linked to higher ACS risk. The SP approach, a newer technique, offers potential benefits in reducing ACS by preserving venous outflow and minimizing intercompartmental pressure. This study aimed to compare ACS and fasciotomy rates between the IP and SP approaches in tibial fracture management. An additional 96 cases were included to strengthen the dataset, providing a comprehensive analysis. This retrospective cohort study included 710 patients treated with IMN for tibial fractures. Of these, 67 patients (70%) from the newly incorporated cases underwent IP nailing, and 29 patients (30%) underwent SP nailing. Data on patient demographics, injury characteristics, surgical techniques, and clinical outcomes were analyzed. Statistical comparisons were conducted using t‐tests and chi‐square tests, with significance set at p<0.05. The fasciotomy rate was significantly higher in the IP group (12.93%) compared to the SP group (0%, p=0.001). Despite a higher proportion of high‐energy trauma cases in the SP group (38.46% vs. 31.38%, p=0.018), ACS and fasciotomy were not observed. Age differences between groups were not statistically significant (p=0.067). Mechanisms of injury, including falls and traffic accidents, showed no significant differences between groups. The suprapatellar approach demonstrated a significant reduction in fasciotomy rates compared to the infrapatellar approach, even in cases of high‐energy trauma. These findings suggest that the SP approach may offer superior outcomes by minimizing ACS risk. This study supports the adoption of the SP approach as a preferred technique for tibial fracture management to reduce complications and enhance recovery.
How to cite this article:
K.C. Mathew, T. Uvarajan and S. Kavin Raja. Comparison of Suprapatellar and Infrapatellar Approaches in Tibial Fracture Management: Impacts on Acute Compartment Syndrome and Fasciotomy Rates.
DOI: https://doi.org/10.36478/10.36478/makrjms.2025.4.37.41
URL: https://www.makhillpublications.co/view-article/1815-9346/10.36478/makrjms.2025.4.37.41