Abstract

Introduction: Proximal tibia fractures are challenging to treat due to their anatomical complexity and high risk of malalignment. Conventional infrapatellar nailing may lead to poor alignment and anterior knee pain, while Minimally Invasive Plate Osteosynthesis (MIPO) has limitations such as longer surgical time and risk of infection. The suprapatellar approach for intramedullary nailing has emerged as a promising alternative for proximal tibia fractures.
Purposes: The aim of study is to evaluate the functional and radiological outcomes of proximal tibia fractures treated with intramedullary nailing (suprapatellar approach), specifically as: time to union, incidence of malalignment, functional outcomes (Lysholm Knee Scoring Scale), Complications (like, anterior knee pain and infection).
Materials and methods: This retrospective study included 30 patients with proximal tibia fractures treated with intramedullary nailing through the suprapatellar approach. Radiological outcomes were assessed based on union time and malalignment, while functional outcomes were measured using the Lysholm Knee Score. Complications such as anterior knee pain and infection were also recorded.
Result: The mean age was 42.6±12.4 years. The average union time was 16.2±2.8 weeks. Malalignment was observed in 2 cases (6.7%), and the mean Lysholm score at final follow-up was 86.5±8.3. Most patients (73.3%) achieved good to excellent functional outcomes. In 3 patients (10%), Anterior knee pain was reported, and 2 cases of infection (superficial) were noted.
Conclusion: Suprapatellar intramedullary nailing of proximal tibia fractures provides excellent alignment, early union, and satisfactory functional outcomes with minimal complications. This approach is a safe and effective alternative to traditional infrapatellar nailing and MIPO lateral plating techniques, particularly in challenging proximal third fractures.

Abbreviations:Suprapatellar approach; Proximal tibia fracture; Intramedullary nailing; Lysholm knee scoring scale; Fracture union; Knee function