Functional and radiological outcome of intramedullary nailing in proximal tibial fractures through supra patellar approach

Background: Proximal third tibial fractures pose complex challenges in orthopaedic trauma care. The choice of surgical approach plays a pivotal role in achieving successful outcomes. This study was conducted to address the significant gap in research regarding the functional and radiological outcomes of the supra patellar approach in intramedullary nailing for proximal tibial fractures. Methods: This prospective cohort study was conducted on a total of 100 patients presenting with proximal tibial fractures. All patients underwent intramedullary nailing using the supra patellar approach. Functional Outcome was assessed using the lower extremity functional scale (LEFS) at 3 weeks, 3 months, and 6 months and 1-year post-surgery. Union status, alignment, and hardware-related complications were assessed through X-rays at each follow-up point to study the radiological outcome. Results: At the end of 1-year follow-up, 88% of patients had an excellent LEFS score,10% had a good LEFS score, and 2% had a fair LEFS score. All patients had a radiological union at 1 year follow up with an average radiological union time being 5.6 (±1.8) months. Conclusions: We advocate for the utilization of suprapatellar nailing as the preferred approach for managing proximal third tibial fractures. This method   consistently yields excellent clinical and radiological outcomes while maintaining a minimal complication rate in comparison to other management modalities.