A Study in Management of Fracture Shaft of Tibia by Intramedullary Nailing by Suprapatellar Approach

Background: Tibial shaft fractures are common and often result from high - energy trauma. Suprapatellar intramedullary (IM) nailing is increasingly favoured for its ability to facilitate fracture reduction, particularly in proximal tibial fractures. Concerns about anterior knee pain and patellofemoral cartilage damage persist. Objective: To assess the functional outcomes, union times, and complications of suprapatellar IM nailing in tibial shaft fractures. Methods: This prospective study included 20 patients treated with suprapatellar IM nailing at Al Ameen Medical College and Hospital from July 2022 to July 2024. Patients were selected based on age (?15 years) and fracture type (closed or Gustilo - Anderson Type I open fractures). Functional outcomes were evaluated using the Lysholm Knee Scoring Scale, while the radiological union was tracked via X - rays at regular intervals over an average follow - up period of 11.5 months. Results: The study included 14 males and 6 females, with an average age of 44 years. The radiological union was achieved in 85% of patients within 16 weeks, with a mean union time of 12.5 weeks. One patient experienced delayed union (26 weeks). Anterior knee pain occurred in 2 patients (10%) but did not significantly affect daily activities. No infections or implant failures were noted. Overall, 70% of patients had excellent functional outcomes, and 30% had good results. Conclusions: Suprapatellar IM nailing is effective for treating tibial shaft fractures, particularly in the proximal third, with excellent functional outcomes and minimal complications.