Knee Function Evaluation Of The Tibial Shaft After Intramedullary Nailing Fixation

Objective:To evaluate the degree of Knee function and incidence rate of pain of the tibial shaft after intramedullary nailing fixation,analyse possible factors resulting in Knee pain.Methods:In a retrospective case study,we evaluated 25 patients with history of closed tibial and fibular shaft fracture who have been treated by IMN from 2007-2-2008-8.Divide the 25 patients transpa-tellar and parapatellar groups.the transpatellar group has 12 cases;the parapatellar group has 13 cases.Score them according the evaluation standard of Knee function.Results:the transpatellar group mean ages is 32.5(18-44),mean follow up times is 7.5 M(4-19);the parapatellar group mean ages is 28.1(19-46),mean follow up times is 10.5 M(4-21).the transp-atellar group score is 86.1±5.4(p＞0.05).the incidence rate of pain is 50%(mild pain),25%(moderate or severe);the parapatellar group score is 90.5±6.7(p＞0.05),he incidence rate of pain is 23%(mild pain),9%(moderate or severe).Conclusion:The patients who suffered from tibial shaft fracture always have some degree of knee joint function disorder after treated by intramedullary nailing(IMN),compared with transpatellar approach,the parapatellar approach has a better knee functiong and a lower pain incidence rate.although there is no relevance between the approach of different nail insertion approaches and post-opertated knee joint function,there is a evident relevance between different nail insertion aPProaches and post-opertated knee joint pain.the factors result of post-opertated knee joint pain include:the direct injury to patellar tendon in transpatellar approach,the injury to knee articular structure of the medullary rasp,the distance butween the upper tip of IMN and tibial plateau.in addition,the qualification of IMN has no relevance with post-opertated knee joint pain.