Radiological and functional assessment of closed tibial shaft fractures treated with interlocking nails through suprapatellar approach: a hospital-based observational study

Abstract

Background: Tibial shaft fractures are among the most frequently encountered long bone injuries. Due to limited soft tissue coverage and subcutaneous location, the tibia is prone to complications such as non-union, infection and malalignment. The suprapatellar approach for intramedullary nailing has recently gained favour for its potential benefits over the traditional infrapatellar method, reducing anterior knee pain and facilitating easier intraoperative imaging. The aim of this study was to assess the radiological and functional outcome of closed tibial shaft fractures treated with interlocking nails through suprapatellar approach. Methods: This prospective observational study was conducted in the Department of Orthopaedics, National Institute of Traumatology and Orthopedics Rehabilitation (NITOR), Sher-E-Bangla Nagar, Dhaka, Bangladesh, from March 2022 to March 2023. Total 33 patients with closed tibial shaft fractures were included in the study. Results: The study included 33 patients (mean age 38.3±11.6 years), predominantly male (69.7%). Right-sided fractures were more common (60.6%). Most injuries (81.8%) were due to motor vehicle accidents. AO type 42A fractures were most frequent (54.5%). Anterior knee pain was minimal, with a mean VAS of 0.5. Radiological union occurred in 90.9% within 21 weeks (mean 17.9±3.5). Complications were rare (12.1%). Most patients achieved a ROM of 130–139°, with fair to good functional outcomes in over 90% of cases. Conclusions: Suprapatellar nailing offers a reliable and minimally painful solution for managing closed tibial shaft fractures with favourable radiological and functional outcomes