Suprapatellar Nailing

Description

This video presentation features Dr. Ashok Gavaskar discussing tips and techniques for performing Suprapatellar Tibial Nailing, a surgical method used to stabilize tibial shaft fractures. Dr. Gavaskar begins by outlining the advantages of nailing in an extended position rather than flexion, emphasizing improved limb control, fluoroscopy access, and ease of fracture reduction. He references the decline in malalignment incidences in recent studies, attributing part of the improvement to the use of suprapatellar techniques.



He elaborates on the critical importance of the entry point's accuracy, particularly over the medial aspect of the lateral tibial spine, and stresses avoiding damage to the patellofemoral joint during the procedure. Attention is given to limb positioning, ensuring proper rotation and imaging to prevent entry point errors. Dr. Gavaskar advises planning for potential fracture deformities and utilizing external fixators or blocking screws for stabilization during nailing.



Throughout the presentation, he provides visuals and diagrams to illustrate the discussed concepts, highlighting common pitfalls such as creating a wide entry point or allowing reamer creep. He concludes that although there are concerns regarding patellofemoral articulation and possible intra-articular injuries, current evidence supports the safety of suprapatellar nailing with no significant increase in infection rates compared to traditional methods.

Specialties