{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T00:41:42Z","timestamp":1760920902757,"version":"build-2065373602"},"reference-count":29,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2015,2,21]],"date-time":"2015-02-21T00:00:00Z","timestamp":1424476800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2015,2,21]],"date-time":"2015-02-21T00:00:00Z","timestamp":1424476800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2016,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The aim of the study was to analyse the patellofemoral alignment in the sagittal plane following tibial fracture surgery with intramedullary nailing and its relationship to parapatellar muscle status.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The patellofemoral MRI results of 27 patients (15\u00a0males and 12 females) treated with locked intramedullary nailing following tibia shaft fracture were reviewed. The mean age of the patients was 41.8 (\u00b115) years. The patella\u2013patellar tendon angle (P\u2010PT) and the distance between the inferior patellar pole and the tibial tubercle (DP\u2010TT) were evaluated for both the operated extremity and the contralateral normal side. MRI assessment of the infrapatellar fat pad, quadriceps, sartorius, gracilis, semi\u2010membranosus muscles and biceps muscles was also carried out. The correlation between the changes in skeletal muscle mass, the volume of the infrapatellar fat pad and the alterations in the DP\u2010TT distances and P\u2010PT angles were analysed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The quadriceps muscle cross\u2010sectional diameter had a mean of 157.2\u00a0mm<jats:sup>2<\/jats:sup> (115.6\/319.5) in the operated extremity, and it was 193\u00a0mm<jats:sup>2<\/jats:sup> (77.6\/282.2) in the non\u2010operated normal side (<jats:italic>p<\/jats:italic> = 0.001). For the Gracilis muscle, the mean was 84.4\u00a0mm<jats:sup>2<\/jats:sup> (19.7\/171) at the operated extremity and 75.7\u00a0mm<jats:sup>2<\/jats:sup> (26.9\/238.2) on the normal side (<jats:italic>p<\/jats:italic> = 0.05). The cross\u2010sectional areas of the semi\u2010membranosus, sartorius and biceps muscles in the operated and non\u2010operated extremity were not noticeably different (n.s). The P\u2010PT angle was 153\u00b0 (129.7\/156.4) in the operated extremity and 145.7\u00b0 (137.6\/163.4) in the non\u2010operated normal extremity (<jats:italic>p<\/jats:italic> &lt; 0.05). While DP\u2010TT distance was 11.4\u00a0mm (9.4\/20.4) in the operated extremity, it was 14.1\u00a0mm (7.3\/17.1) in the non\u2010operated extremity (<jats:italic>p<\/jats:italic> = 0.001). The correlation analyses revealed that the quadriceps hypotrophy negatively correlated (<jats:italic>r<\/jats:italic> = \u22120.4, <jats:italic>p<\/jats:italic> = 0.02) with the P\u2010PT angle but positively correlated with the increase in gracilis muscle volume (<jats:italic>r<\/jats:italic> = 0.4, <jats:italic>p<\/jats:italic> = 0.03).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study revealed that patellofemoral joint kinematics in the operated extremity was diminished in the sagittal plane correlating with the quadriceps muscle volume loss and gracilis muscle hypertrophy. The modalities focused on both preventing and treating the hypotrophy of the quadriceps muscle following the surgical treatment of tibial fracture, which may help to overcome this quite common pathology.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-015-3533-8","type":"journal-article","created":{"date-parts":[[2015,2,20]],"date-time":"2015-02-20T09:04:27Z","timestamp":1424423067000},"page":"2878-2883","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Sagittal patellar tilt and concomitant quadriceps hypotrophy after tibial nailing"],"prefix":"10.1002","volume":"24","author":[{"given":"Ertugrul","family":"Aksahin","sequence":"first","affiliation":[{"name":"Orthopedics and Traumatology Department Ankara Education and Research Hospital Street 89\/3 Bah\u00e7elievler\/Cankaya 06500 Ankara Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Serdar","family":"Yilmaz","sequence":"additional","affiliation":[{"name":"Orthopedics and Traumatology Department Ankara Numune Education and Research Hospital Ankara Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ismail","family":"Karasoy","sequence":"additional","affiliation":[{"name":"Orthopedics and Traumatology Department Ankara Numune Education and Research Hospital Ankara Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Semra","family":"Duran","sequence":"additional","affiliation":[{"name":"Radiology Department Ankara Numune Education and Research Hospital Ankara Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H. Yalcin","family":"Yuksel","sequence":"additional","affiliation":[{"name":"Orthopedics and Traumatology Department Antalya Training and Research Hospital Antalya Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ozgur","family":"Dogan","sequence":"additional","affiliation":[{"name":"Orthopedics and Traumatology Department Ankara Numune Education and Research Hospital Ankara Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. Ozgur","family":"Yildirim","sequence":"additional","affiliation":[{"name":"Orthopedics and Traumatology Department Ankara Numune Education and Research Hospital Ankara Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali","family":"Bicimoglu","sequence":"additional","affiliation":[{"name":"Orthopedics and Traumatology Department Ankara Numune Education and Research Hospital Ankara Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,2,21]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"crossref","first-page":"S26","DOI":"10.1016\/S0020-1383(13)70109-8","article-title":"Anterior knee pain after tibial nailing: What is the role of patellofemoral joint kinematics?","volume":"44","author":"Aksahin E","year":"2013","journal-title":"Injury"},{"key":"e_1_2_7_3_1","doi-asserted-by":"crossref","first-page":"S26","DOI":"10.1016\/S0020-1383(13)70108-6","article-title":"Does the change in the mass of 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