{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T08:53:14Z","timestamp":1781686394090,"version":"3.54.5"},"reference-count":20,"publisher":"EDP Sciences","license":[{"start":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T00:00:00Z","timestamp":1781740800000},"content-version":"vor","delay-in-days":168,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SICOT-J"],"accepted":{"date-parts":[[2026,5,19]]},"published-print":{"date-parts":[[2026]]},"abstract":"<jats:p>\n                    <jats:italic>Background<\/jats:italic>\n                    : Anterior knee pain (AKP) is a frequent complaint after tibial intramedullary nailing (IMN), and the choice of entry approach may contribute to its occurrence. This trial compared the lateral parapatellar semi-extended (LPP) approach versus the midline transpatellar splitting (MLTP) approach for IMN of closed diaphyseal tibial fractures, focusing on AKP and knee function.\n                    <jats:italic>Methods<\/jats:italic>\n                    : In this single-blinded randomized controlled trial, 50 adults with acute closed AO\/OTA 42 tibial shaft fractures were allocated 1:1 to IMN performed through either the LPP or MLTP approach. Follow-up assessments were performed at 3 and 6 months after surgery. Primary outcomes were AKP during weight-bearing, quantified using a visual analog scale (VAS), and knee function measured by the Lysholm Knee Score.\n                    <jats:italic>Results<\/jats:italic>\n                    : LPP achieved higher Lysholm scores at 3 months (82.36 \u00b1 5.2 vs. 75.76 \u00b1 6.1;\n                    <jats:italic>P<\/jats:italic>\n                    &lt; 0.001) and 6 months (87.32 \u00b1 4.8 vs. 84.20 \u00b1 5.4;\n                    <jats:italic>P<\/jats:italic>\n                    = 0.024), indicating superior early functional recovery. VAS AKP was lower with LPP at 3 months (2.40 \u00b1 0.9 vs. 3.60 \u00b1 1.2;\n                    <jats:italic>P<\/jats:italic>\n                    = 0.001), but similar by 6 months (1.80 \u00b1 0.7 vs. 1.96 \u00b1 0.8;\n                    <jats:italic>P<\/jats:italic>\n                    = 0.122), suggesting the benefit is mainly early. Operative time favored LPP (62.1 \u00b1 8.7 vs. 68.4 \u00b1 10.2 min;\n                    <jats:italic>P<\/jats:italic>\n                    = 0.02) with fewer fluoroscopy shots (29.2 \u00b1 5.4 vs. 38.5 \u00b1 6.1;\n                    <jats:italic>P<\/jats:italic>\n                    &lt; 0.001). All fractures united; time to union was comparable (16.8 \u00b1 2.4 vs. 16.2 \u00b1 2.1 weeks;\n                    <jats:italic>P<\/jats:italic>\n                    = 0.41). Complications were minor in both groups.\n                    <jats:italic>Conclusions<\/jats:italic>\n                    : LPP semi-extended tibial IMN was associated with lower early AKP, better early knee function, and improved operative efficiency without compromising union during 6-month follow-up. A Longer follow-up is required to determine whether anterior knee pain and functional outcomes converge over time.\n                  <\/jats:p>","DOI":"10.1051\/sicotj\/2026042","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T08:01:06Z","timestamp":1781683266000},"page":"39","source":"Crossref","is-referenced-by-count":0,"title":["Lateral parapatellar approach versus transpatellar splitting approach in intramedullary nailing of diaphyseal tibia fractures, a prospective randomized controlled study"],"prefix":"10.1051","volume":"12","author":[{"given":"Amr Amal","family":"Amin","sequence":"first","affiliation":[{"name":"Orthopedic Surgery Department, Faculty of Medicine, Ain Shams University","place":["Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"El Zaher","family":"Hassan El Zaher","sequence":"additional","affiliation":[{"name":"Orthopedic Surgery Department, Faculty of Medicine, Ain Shams University","place":["Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Youssef Mohamed Abd-El Salam","family":"Wafa","sequence":"additional","affiliation":[{"name":"Orthopedic Surgery Department, Faculty of Medicine, Ain Shams University","place":["Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed Mohamed Khaled","family":"El Ghazawy","sequence":"additional","affiliation":[{"name":"Orthopedic Surgery Department, Faculty of Medicine, Ain Shams University","place":["Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amr Mohamed","family":"Nagy","sequence":"additional","affiliation":[{"name":"Orthopedic Surgery Department, Faculty of Medicine, Ain Shams University","place":["Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"250","published-online":{"date-parts":[[2026,6,18]]},"reference":[{"issue":"4","key":"R1","doi-asserted-by":"crossref","first-page":"746","DOI":"10.1016\/j.injury.2014.12.027","volume":"46","author":"Larsen","year":"2015","journal-title":"Injury"},{"issue":"3","key":"R2","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/j.jcot.2017.07.012","volume":"8","author":"Anandasivam","year":"2017","journal-title":"J Clin Orthop Trauma"},{"issue":"1","key":"R3","first-page":"Cd008241","volume":"1","author":"Duan","year":"2012","journal-title":"Cochrane Database Syst Rev"},{"issue":"5","key":"R4","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1302\/0301-620X.88B5.16875","volume":"88","author":"Katsoulis","year":"2006","journal-title":"J Bone Joint Surg Br"},{"issue":"8","key":"R5","first-page":"e17404","volume":"13","author":"Khan","year":"2021","journal-title":"Cureus"},{"issue":"3","key":"R6","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1097\/BOT.0b013e3182217fe6","volume":"26","author":"Song","year":"2012","journal-title":"J Orthop Trauma"},{"issue":"6","key":"R7","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1016\/j.injury.2011.09.002","volume":"43","author":"Leliveld","year":"2012","journal-title":"Injury"},{"issue":"2","key":"R8","doi-asserted-by":"crossref","first-page":"16","DOI":"10.5704\/MOJ.1607.004","volume":"10","author":"Soraganvi","year":"2016","journal-title":"Malays Orthop J"},{"key":"R9","doi-asserted-by":"crossref","unstructured":"Parikh S, Marsh L, Anderson M, Scott J, Patel A, Hendrix C, et al. 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