Comparison between midline tendon splitting and lateral parapatellar approach for intramedullary nailing of tibia

Introduction: Tibial fracture unites well with classical midline tendon splitting approach but are associated with complications. So fractures stabilization with IMILN via lateral parapatellar approach is useful to prevent complications. Methods: In our comparative study 30 patients in each MTS and LP approach, underwent IMILN. Main Outcome Measurements: Anterior knee pain based on a visual analog scale and functional outcomes based on Lysholm knee score. Results: Results were excellent in 20% of patients, good in 80% of patients in lateral parapatellar approach. Whereas, in midline tendon splitting approach results were excellent in 7% of patients, good in 67 % of patients, fair in 27 % patients at 1 year, according to LKS. The descending order of the activities with respect to severity of knee pain was kneeling, squatting, running, and stair ascending. VAS analysis revealed that the LP group had significantly less severe pain for all eight activities examined than the MTS group. However, at 1 yr both are comparable. Conclusion: IMILN with lateral parapatellar approach has good functional outcome and is better than midline tendon splitting approach.