Anterior Knee Pain after Intramedullary Nailing of Fractures of the Tibial Shaft

Abstract

Introduction: Intramedullary nailing is the treatment of choice for displaced tibial shaft fractures in adults. Chronic anterior knee pain at the insertion site of the nail is the most frequently reported complication of closed nailing. The cause of knee pain is still unclear. Many etiological factors have been put forward. Aim of the Study: The aim of the study was to determine the incidence and the factors leading to anterior Knee pain following tibial nailing. Materials and Methods: A retrospective analysis of patients treated by tibial nailing in our hospital from the year January 2015 to December 2017 was done. Groups of 85 patients with 86 tibial fractures were studied. Their clinical record radiographs were analyzed. Patients were contacted and interviewed. Results: At a mean follow-up of 2 years, 48 patients (55.81%) had knee pain. 20 patients had nail protrusion, of which 9 had knee pain. 14 patients had nail removed, of which 8 had complete pain relief. Conclusion: Based on our findings, there was no correlation between nail protrusion and knee pain. Nail removal helped in relieving pain. The causes of knee pain after tibial nailing are multifactorial and require further evaluation.