A Prospective Study of Functional Outcome Following Intramedullary Nailing in Diaphyseal Fractures of the Tibia

Abstract Background: Tibial diaphyseal fractures represent one of the most common long bone fractures requiring surgical intervention. Intramedullary nailing has evolved as the preferred treatment modality for displaced tibial shaft fractures, offering advantages of biomechanical stability, minimal soft tissue disruption, and early mobilization. However, comprehensive prospective data evaluating functional outcomes in the Indian population remains limited. This study prospectively evaluated the functional outcomes and complications following intramedullary nailing in tibial diaphyseal fractures. Methods: This prospective observational study was conducted over 18 months, including 80 patients with closed and Gustilo type I open tibial diaphyseal fractures treated with reamed intramedullary interlocking nailing. Patients were followed for a minimum of 12 months. Functional outcomes were assessed using the Johner-Wruhs criteria at 6 and 12 months post-operatively. Radiological union, complications, and time to full weight-bearing were recorded. Statistical analysis was performed using SPSS version 25.0. Results: The mean age of patients was 38.7 years with male predominance. Road traffic accidents accounted for 71.25% of injuries. Union was achieved in 92.5% of patients at a mean duration of 18.3 weeks. At 12-month follow-up, excellent to good functional outcomes were observed in 83.75% of patients according to Johner-Wruhs criteria. Complications included anterior knee pain, superficial infection, malunion, and non-union. The mean time to full weight-bearing was 14.6 weeks. Conclusion: Intramedullary nailing for tibial diaphyseal fractures demonstrated excellent functional outcomes with acceptable complication rates. The procedure allows early mobilization and satisfactory return to pre-injury functional status in the majority of patients.