{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T18:50:03Z","timestamp":1793040603374,"version":"4.5.0"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,9,17]],"date-time":"2020-09-17T00:00:00Z","timestamp":1600300800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,9,17]],"date-time":"2020-09-17T00:00:00Z","timestamp":1600300800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100011710","name":"Shaanxi Provincial Science and Technology Department","doi-asserted-by":"publisher","award":["2015SF116, 2016SF-340"],"award-info":[{"award-number":["2015SF116, 2016SF-340"]}],"id":[{"id":"10.13039\/501100011710","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Orthop Surg Res"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study aimed to analyze and compare the clinical and functional outcomes of distal tibia fractures treated with intramedullary nailing (IMN) using the suprapatellar (SP) and infrapatellar (IP) surgical approaches.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective analysis was performed in 63 patients with distal fractures that were treated with IMN between August 2014 and August 2018. A total of 27 and 36 patients underwent IMN using the SP and IP techniques, respectively. The surgical time, blood loss, closed reduction rate, rate of adjuvant reduction technique, fracture healing time, and complications were reviewed in this study. Anterior knee pain was assessed using the visual analog scale. The Lysholm Knee Scoring Scale and American Orthopaedic Foot and Ankle Society (AOFAS) scale were used as clinical measurements.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 63 patients, with a minimum follow-up of 12\u2009months, were evaluated. The average surgical time, blood loss, rate of adjuvant reduction technique, closed reduction rate, fracture healing time, and Lysholm Knee Scoring Scale score were insignificantly different (\n                      <jats:italic>P<\/jats:italic>\n                      &gt; 0.05) between the two groups. However, the SP approach was superior to the IP approach in terms of pain score, AOFAS score, and fracture deformity rate (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In the treatment of distal tibia fractures, the SP IMN technique is associated with a significantly higher functional outcome, lower knee pain, and lower rate of fracture deformity than the IP IMN technique.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13018-020-01960-8","type":"journal-article","created":{"date-parts":[[2020,9,17]],"date-time":"2020-09-17T11:15:30Z","timestamp":1600341330000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Comparison of suprapatellar versus infrapatellar approaches of intramedullary nailing for distal tibia fractures"],"prefix":"10.1186","volume":"15","author":[{"given":"Yao","family":"Lu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gen","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng","family":"Ren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liang","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhimeng","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changjun","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanzhong","family":"Xue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhong","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kun","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teng","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,9,17]]},"reference":[{"key":"1960_CR1","volume-title":"StatPearls","author":"JH Thompson","year":"2020","unstructured":"Thompson JH, Jahangir A. Tibia fractures overview. In: StatPearls. Treasure island: StatPearls Publishing; 2020."},{"issue":"3","key":"1960_CR2","doi-asserted-by":"publisher","first-page":"e29","DOI":"10.2106\/JBJS.ST.18.00093","volume":"9","author":"TH Carter","year":"2019","unstructured":"Carter TH, Duckworth AD, Oliver WM, et al. Open reduction and internal fixation of distal tibial pilon fractures. JBJS Essent Surg Tech. 2019;9(3):e29. Published 2019 Sep 11. https:\/\/doi.org\/10.2106\/JBJS.ST.18.00093.","journal-title":"JBJS Essent Surg Tech"},{"issue":"12","key":"1960_CR3","doi-asserted-by":"publisher","first-page":"736","DOI":"10.1097\/BOT.0b013e318213f709","volume":"25","author":"HA Vallier","year":"2011","unstructured":"Vallier HA, Cureton BA, Patterson BM. Randomized, prospective comparison of plate versus intramedullary nail fixation for distal tibia shaft fractures. J Orthop Trauma. 2011;25(12):736\u201341. https:\/\/doi.org\/10.1097\/BOT.0b013e318213f709.","journal-title":"J Orthop Trauma"},{"issue":"3","key":"1960_CR4","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1016\/j.ocl.2014.04.001","volume":"45","author":"RD Richard","year":"2014","unstructured":"Richard RD, Kubiak E, Horwitz DS. Techniques for the surgical treatment of distal tibia fractures [J]. Orthop Clin North Am. 2014;45(3):295\u2013312. https:\/\/doi.org\/10.1016\/j.ocl.2014.04.001.","journal-title":"Orthop Clin North Am"},{"issue":"1","key":"1960_CR5","doi-asserted-by":"publisher","first-page":"52","DOI":"10.5505\/tjtes.2015.82026","volume":"22","author":"D G\u00fclabi","year":"2016","unstructured":"G\u00fclabi D, Bekler H\u0130, Sa\u011flam F, et al. Surgical treatment of distal tibia fractures: open versus MIPO. Ulus Travma Acil Cerrahi Derg. 2016;22(1):52\u20137. https:\/\/doi.org\/10.5505\/tjtes.2015.82026.","journal-title":"Ulus Travma Acil Cerrahi Derg"},{"issue":"10","key":"1960_CR6","doi-asserted-by":"publisher","first-page":"975","DOI":"10.1016\/j.injury.2010.02.019","volume":"42","author":"SD Newman","year":"2011","unstructured":"Newman SD, Mauffrey CP, Krikler S. Distal metadiaphyseal tibial fractures. Injury. 2011;42(10):975\u201384. https:\/\/doi.org\/10.1016\/j.injury.2010.02.019.","journal-title":"Injury"},{"issue":"11","key":"1960_CR7","doi-asserted-by":"publisher","first-page":"e454","DOI":"10.1097\/BOT.0000000000000377","volume":"29","author":"J Zhang","year":"2015","unstructured":"Zhang J, Ebraheim NA, Li M, et al. External fixation using a locking plate: a reliable way in treating distal tibial fractures. J Orthop Trauma. 2015;29(11):e454\u20138. https:\/\/doi.org\/10.1097\/BOT.0000000000000377.","journal-title":"J Orthop Trauma"},{"issue":"11","key":"1960_CR8","doi-asserted-by":"publisher","first-page":"2245","DOI":"10.1007\/s00264-015-2906-4","volume":"39","author":"K Pi\u0105tkowski","year":"2015","unstructured":"Pi\u0105tkowski K, Piekarczyk P, Kwiatkowski K, et al. Comparison of different locking plate fixation methods in distal tibia fractures. Int Orthop. 2015;39(11):2245\u201351. https:\/\/doi.org\/10.1007\/s00264-015-2906-4.","journal-title":"Int Orthop"},{"issue":"4","key":"1960_CR9","doi-asserted-by":"publisher","first-page":"e35.1","DOI":"10.2106\/JBJS.ST.18.00112","volume":"9","author":"RM Natoli","year":"2019","unstructured":"Natoli RM, Sardesai NR, Richard RD, et al. Intramedullary nailing of lower-extremity periarticular fractures. JBJS Essent Surg Tech. 2019;9(4):e35.1\u20132. https:\/\/doi.org\/10.2106\/JBJS.ST.18.00112.","journal-title":"JBJS Essent Surg Tech."},{"issue":"6","key":"1960_CR10","doi-asserted-by":"publisher","first-page":"954","DOI":"10.1111\/os.12575","volume":"11","author":"XK Liu","year":"2019","unstructured":"Liu XK, Xu WN, Xue QY, et al. Intramedullary nailing versus minimally invasive plate osteosynthesis for distal tibial fractures: a systematic review and meta-analysis. Orthop Surg. 2019;11(6):954\u201365. https:\/\/doi.org\/10.1111\/os.12575.","journal-title":"Orthop Surg."},{"issue":"1","key":"1960_CR11","doi-asserted-by":"publisher","first-page":"456","DOI":"10.1186\/s13018-019-1479-0","volume":"14","author":"B Wang","year":"2019","unstructured":"Wang B, Zhao Y, Wang Q, et al. Minimally invasive percutaneous plate osteosynthesis versus intramedullary nail fixation for distal tibial fractures: a systematic review and meta-analysis. J Orthop Surg Res. 2019;14(1):456. https:\/\/doi.org\/10.1186\/s13018-019-1479-0.","journal-title":"J Orthop Surg Res."},{"issue":"7","key":"1960_CR12","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1177\/107110079401500701","volume":"15","author":"HB Kitaoka","year":"1994","unstructured":"Kitaoka HB, Alexander IJ, Adelaar RS, et al. Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int. 1994;15(7):349\u201353. 0198-021119411507-0349S03.00\/0.","journal-title":"Foot Ankle Int"},{"issue":"5","key":"1960_CR13","doi-asserted-by":"publisher","first-page":"490","DOI":"10.1177\/036354659001800508","volume":"18","author":"JP Fulkerson","year":"1990","unstructured":"Fulkerson JP, Becker GJ, Meaney JA, et al. Anteromedial tibial tubercle transfer without bone graft. Am J Sports Med. 1990;18(5):490\u20137. https:\/\/doi.org\/10.1177\/036354659001800508.","journal-title":"Am J Sports Med."},{"issue":"1","key":"1960_CR14","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1007\/s001320050004","volume":"29","author":"D Paley","year":"2000","unstructured":"Paley D, Pfeil J. Principles of deformity correction around the knee. Orthopade. 2000;29(1):18\u201338. https:\/\/doi.org\/10.1007\/s001320050004.","journal-title":"Orthopade."},{"issue":"7","key":"1960_CR15","doi-asserted-by":"publisher","first-page":"767","DOI":"10.1016\/j.injury.2009.01.117","volume":"40","author":"J Horn","year":"2009","unstructured":"Horn J, Linke B, H\u00f6ntzsch D, et al. Angle stable interlocking screws improve construct stability of intramedullary nailing of distal tibia fractures: a biomechanical study. Injury. 2009;40(7):767\u201371. https:\/\/doi.org\/10.1016\/j.injury.2009.01.117.","journal-title":"Injury."},{"issue":"1","key":"1960_CR16","doi-asserted-by":"publisher","first-page":"573","DOI":"10.1186\/s12891-019-2961-x","volume":"20","author":"Y Cui","year":"2019","unstructured":"Cui Y, Hua X, Schmidutz F, et al. Suprapatellar versus infrapatellar approaches in the treatment of tibia intramedullary nailing: a retrospective cohort study. BMC Musculoskelet Disord. 2019;20(1):573. https:\/\/doi.org\/10.1186\/s12891-019-2961-x.","journal-title":"BMC Musculoskelet Disord."},{"issue":"1","key":"1960_CR17","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1186\/s13018-018-0846-6","volume":"13","author":"L Yang","year":"2018","unstructured":"Yang L, Sun Y, Li G. Comparison of suprapatellar and infrapatellar intramedullary nailing for tibial shaft fractures: a systematic review and meta-analysis. J Orthop Surg Res. 2018;13(1):146. Published 2018 Jun 14. https:\/\/doi.org\/10.1186\/s13018-018-0846-6.","journal-title":"J Orthop Surg Res"},{"key":"1960_CR18","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1016\/j.ijsu.2018.01.026","volume":"51","author":"C Wang","year":"2018","unstructured":"Wang C, Chen E, Ye C, et al. Suprapatellar versus infrapatellar approach for tibia intramedullary nailing: a meta-analysis. Int J Surg. 2018;51:133\u20139. https:\/\/doi.org\/10.1016\/j.ijsu.2018.01.026.","journal-title":"Int J Surg."},{"issue":"9","key":"1960_CR19","doi-asserted-by":"publisher","first-page":"1138","DOI":"10.1302\/0301-620X.101B9.BJJ-2018-1115.R2","volume":"101-B","author":"DRW MacDonald","year":"2019","unstructured":"MacDonald DRW, Caba-Doussoux P, Carnegie CA, et al. Tibial nailing using a suprapatellar rather than an infrapatellar approach significantly reduces anterior knee pain postoperatively: a multicentre clinical trial. Bone Joint J. 2019;101-B(9):1138\u201343. https:\/\/doi.org\/10.1302\/0301-620X.101B9.BJJ-2018-1115.R2.","journal-title":"Bone Joint J."},{"issue":"2 Suppl","key":"1960_CR20","doi-asserted-by":"publisher","first-page":"S153","DOI":"10.1097\/TA.0b013e3181607750","volume":"64","author":"AE Ritenour","year":"2008","unstructured":"Ritenour AE, Dorlac WC, Fang R, et al. Complications after fasciotomy revision and delayed compartment release in combat patients. J Trauma. 2008;64(2 Suppl):S153\u201362. https:\/\/doi.org\/10.1097\/TA.0b013e3181607750.","journal-title":"J Trauma."},{"key":"1960_CR21","doi-asserted-by":"publisher","first-page":"119","DOI":"10.4103\/2277-9175.133187","volume":"3","author":"MA Tahririan","year":"2014","unstructured":"Tahririan MA, Ziaei E, Osanloo R. Significance of the position of the proximal tip of the tibial nail: an important factor related to anterior knee pain. Adv Biomed Res. 2014;3:119. https:\/\/doi.org\/10.4103\/2277-9175.133187.","journal-title":"Adv Biomed Res."},{"issue":"12","key":"1960_CR22","first-page":"E513","volume":"44","author":"PM Courtney","year":"2015","unstructured":"Courtney PM, Boniello A, Donegan D, et al. Functional knee outcomes in infrapatellar and suprapatellar tibial nailing: does approach matter? Am J Orthop (Belle Mead NJ). 2015;44(12):E513\u20136.","journal-title":"Am J Orthop (Belle Mead NJ)."},{"key":"1960_CR23","doi-asserted-by":"publisher","first-page":"e3319","DOI":"10.1136\/bmj.e3319","volume":"344","author":"DJ McMinn","year":"2012","unstructured":"McMinn DJ, Snell KI, Daniel J, et al. Mortality and implant revision rates of hip arthroplasty in patients with osteoarthritis: registry based cohort study. BMJ. 2012;344:e3319. Published 2012 Jun 14. https:\/\/doi.org\/10.1136\/bmj.e3319.","journal-title":"BMJ"},{"issue":"10","key":"1960_CR24","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1097\/BOT.0000000000000631","volume":"30","author":"FR Avilucea","year":"2016","unstructured":"Avilucea FR, Triantafillou K, Whiting PS, et al. Suprapatellar intramedullary nail technique lowers rate of malalignment of distal tibia fractures. J Orthop Trauma. 2016;30(10):557\u201360. https:\/\/doi.org\/10.1097\/BOT.0000000000000631.","journal-title":"J Orthop Trauma."},{"issue":"10","key":"1960_CR25","doi-asserted-by":"publisher","first-page":"e366","DOI":"10.1097\/BOT.0000000000001554","volume":"33","author":"M Stella","year":"2019","unstructured":"Stella M, Santolini E, Felli L, et al. Semiextended tibial nail insertion using an extraarticular lateral parapatellar approach: a 24-month follow-up prospective cohort study. J Orthop Trauma. 2019;33(10):e366\u201371. https:\/\/doi.org\/10.1097\/BOT.0000000000001554.","journal-title":"J Orthop Trauma."},{"key":"1960_CR26","first-page":"25","volume":"315","author":"EL Freedman","year":"1995","unstructured":"Freedman EL, Johnson EE. Radiographic analysis of tibial fracture malalignment following intramedullary nailing. Clin Orthop Relat Res. 1995;315:25\u201333.","journal-title":"Clin Orthop Relat Res."},{"key":"1960_CR27","doi-asserted-by":"publisher","unstructured":"Tornetta P 3rd, Collins E. Semiextended position of intramedullary nailing of the proximal tibia. Clin Orthop Relat Res. 1996;(328):185\u20139. https:\/\/doi.org\/10.1097\/00003086-199607000-00029.","DOI":"10.1097\/00003086-199607000-00029"},{"issue":"3","key":"1960_CR28","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1016\/j.ocl.2019.03.007","volume":"50","author":"GA Busel","year":"2019","unstructured":"Busel GA, Mir H. Suprapatellar tibial nailing. Orthop Clin North Am. 2019;50(3):289\u201395. https:\/\/doi.org\/10.1016\/j.ocl.2019.03.007.","journal-title":"Orthop Clin North Am."},{"key":"1960_CR29","doi-asserted-by":"publisher","unstructured":"Hessmann MH, Buhl M, Finkemeier C, et al. Suprapatellar nailing of fractures of the tibia. Oper Orthop Traumatol. 2020. https:\/\/doi.org\/10.1007\/s00064-020-00649-9.","DOI":"10.1007\/s00064-020-00649-9"}],"container-title":["Journal of Orthopaedic Surgery and Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13018-020-01960-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13018-020-01960-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13018-020-01960-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,16]],"date-time":"2021-09-16T19:24:28Z","timestamp":1631820268000},"score":1,"resource":{"primary":{"URL":"https:\/\/josr-online.biomedcentral.com\/articles\/10.1186\/s13018-020-01960-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,17]]},"references-count":29,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["1960"],"URL":"https:\/\/doi.org\/10.1186\/s13018-020-01960-8","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-19065\/v1","asserted-by":"object"},{"id-type":"doi","id":"10.21203\/rs.3.rs-19065\/v2","asserted-by":"object"},{"id-type":"doi","id":"10.21203\/rs.3.rs-17814\/v1","asserted-by":"object"}]},"ISSN":["1749-799X"],"issn-type":[{"value":"1749-799X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9,17]]},"assertion":[{"value":"24 March 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 September 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 September 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This study was approved by the ethics committee of Honghui Hospital, Xi\u2019an Jiaotong University. All patients provided informed consent prior to participation in the study.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Yes.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"422"}}