A prospective study on the functional and radiological outcome of suprapatellar and infrapatellar intramedullary nailing for proximal tibia extra-articular fractures

The most effective therapy for proximal tibia extra-articular fractures, which are among the most frequent long bone fractures, is intramedullary nailing. With each technique offering distinct benefits and disadvantages, the decision between suprapatellar and infrapatellar techniques for intramedullary nailing is still up for debate. The purpose of this study is to compare the radiological and functional results of these two methods. The aim of this study is to compare the functional and radiological outcomes of suprapatellar and infrapatellar intramedullary nailing techniques in the management of proximal tibia extra-articular fractures. In this randomized controlled research, 40 patients with proximal tibia extra-articular fractures were randomized to either the Infrapatellar group (n = 20) or the Suprapatellar group (n = 20). At 1, 3 and 6 months following surgery, the Lower Extremity Functional Scale (LEFS) and the Lysholm Knee Score were used to evaluate functional outcomes. The Visual Analog Scale (VAS) was used to gauge pain levels and radiographic results were evaluated for alignment and fracture healing. T-tests and other statistical analyses were used to compare the groups. The functional outcomes at 3 and 6 months after surgery were noticeably better for the suprapatellar group. The Suprapatellar group's Lysholm Knee Score at 6 months was substantially higher (92.2 ± 5.35) than that of the Infrapatellar group (87.95 ± 5.34, p = 0.016). Similarly, the Suprapatellar group had a higher LEFS score at 6 months (88.20 ± 4.54) than the Infrapatellar group (82.10 ± 5.86, p = 0.025). Additionally, the Suprapatellar group experienced less discomfort, with a mean VAS score of 2.0 (±0.30) being lower than the Infrapatellar group's 2.50 (±0.50) (p = 0.001). When treating proximal tibia extra-articular fractures, this study shows that suprapatellar nailing produces better functional outcomes with reduced pain than infrapatellar nailing. These results suggest that the Suprapatellar method is a better choice for treating proximal tibia extra-articular fractures.