A Novel Technique for Obtaining Neutral Entrance Angle During Suprapatellar Nailing of Tibial Shaft Fractures

Fractures of the tibial shaft are often treated with intramedullary nailing. Despite advances of implants and surgical techniques such as suprapatellar nailing, certain fracture patterns can still pose challenges in obtaining adequate fracture reductions. Difficulty obtaining a proper starting position with a neutral entrance angle can be difficult with the suprapatellar technique. Use of a cannulated awl can improve the ease and accuracy of attaining the correct start point and facilitate treatment of these complex fractures. Our purpose was to describe the novel use of a curved, cannulated awl to improve the ease and accuracy of obtaining the correct starting point and neutral entrance angle in suprapatellar nailing of tibial shaft fractures. Using this curved, cannulated awl is a novel technique that surgeons can employ to obtain a correct starting point and neutral entrance angle more easily when treating tibial shaft fractures with suprapatellar nailing. (Journal of Surgical Orthopaedic Advances 32(2):130–132, 2023)

Key words: tibial shaft fracture, suprapatellar, intramedullary nail, technique