title: No Incidence of Postoperative Knee Sepsis With Suprapatellar Nailing of Open Tibia Fractures.
abstract: OBJECTIVE
  To evaluate the incidence of knee sepsis after suprapatellar (SP) nailing of open tibia fractures.
  
  
  METHODS
  Retrospective; Setting: ACS level 1 trauma center.
  
  
  METHODS
  We reviewed 139 open tibia fractures that underwent SP nailing as definitive treatment over a 5-year period (January 1, 2011 to January 1, 2016). Most patients (90%, n = 126) underwent intramedullary nailing at the time of their initial surgery. We defined knee sepsis as intra-articular infection requiring operative debridement, either open or arthroscopically, within 1 month's time.
  
  
  METHODS
  Open tibia fractures treated with an SP tibial nail.
  
  
  METHODS
  Demographic data, fracture characteristics, Gustilo and Anderson classification of open fractures, and occurrence of knee sepsis.
  
  
  RESULTS
  In 139 open tibia fractures, there were no cases of knee sepsis in the 30 days after treatment with an SP intramedullary nail. Eighty-seven percent of our cohort had Gustilo and Anderson type II (41%) or type III (46%) open fractures. Most open fractures (83%) underwent primary wound closure during the index procedures. Twenty-five limbs (18%) had evidence of infection at the open fracture site of their open fracture necessitating operative intervention and/or antibiotics: none, however, developed knee sepsis.
  
  
  CONCLUSIONS
  Although the SP approach carries intra-articular risks, we found a low risk of knee sepsis using this technique in the treatment of open tibia fractures. Our data suggest that there is no greater risk of intra-articular infection using an SP portal as compared with an infrapatellar one.
  
  
  METHODS
  Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
authors.affiliation: Department of Orthopaedics, Vanderbilt University Medical Center, Nashville, TN.
authors.forename: Phillip M
authors.initials: PM
authors.lastname: Mitchell
authors.forename: Benjamin M
authors.initials: BM
authors.lastname: Weisenthal
authors.forename: Cory A
authors.initials: CA
authors.lastname: Collinge
mesh_terms: D017677:Age Distribution; D015984:Causality; D015897:Comorbidity; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000706:statistics & numerical data*; D005597:Fractures, Open / Q000453:epidemiology* / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D010329:Patella / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D018805:Sepsis; D017678:Sex Distribution; D013530:Surgical Wound Infection / Q000453:epidemiology*; D013714:Tennessee / Q000453:epidemiology; D013978:Tibial Fractures / Q000453:epidemiology* / Q000601:surgery*; D016896:Treatment Outcome