Abstract:

Objective To compare the effect of three different surgical approaches for intramedullarynailing for tibia fractures. Methods A retrospective analysis was conducted of the 99 patients with tibial fracturewho had been treated from January 2018 to 2019 and completed follow⁃ups，there were 69 males and 30 females，with an average age of 47 years（range from 18 to 65 years），33 were treated through suprapatellar approach，30 weretreated through infrapatellar approach and 36 were treated through parapatellar approach，The operative time，bloodloss，times of X⁃ray exposure，length of hospital stay，fracture healing time，lysholm scoring，anterior knee pain，removal time of internal fixation，complication rate and postoperative excellence rate were recorded and comparedamong the three groups. The data were analyzed by SPSS22.0. Results In the parapatellar approach group，theoperative time，blood loss，times of X⁃ray exposure，length of hospital stay and anterior knee pain were shorter，thelysholm scoring was highest. The difference was statistically significant（P＜0.05）. There were no significantlydifference in the postoperative excellence rate，complication rate，blood loss and removal time of internal fixation（P＞0.05）. Conclusion Different surgical approach are factors related to treatment of tibial fracture. The parapatellarapproach for tibial fractures doesn′t injury of ligamentumpatellae and patellofemoral，it also has the advantages ofshorter operative time，less times of X⁃ray exposure，less pain and fewer complications，may be choosed firstly

Key words: intramedullary nail , tibial shaft fracture , suprapatellar approach , transpatellar approach, parapatellar approach