Functional and radiological outcomes of suprapatellar intramedullary nailing for tibia diaphyseal fracture-an observational study

Background: For tibial shaft fractures, intramedullary nailing (IMN) is considered the preferred treatment because it has a high fracture union rate, allows early mobilization, reduces complications such as infection, malunion, non-union or implant failure, and provides early stabilization, which decreases morbidity and mortality. Methods: The purpose of this study is to evaluate the functional and radiological outcomes of tibia diaphyseal fractures treated with intramedullary nailing through a suprapatellar approach from 2019 to 2021. Lower Extremity Functional Score (LEFS) was used to measure subjective functional outcomes, and knee range of motion (ROM) was used to measure objective functional outcomes, Radiological outcome was determined by the time of union of the fracture, pain scores were assessed by visual analogue scale (VAS) and fluoroscopy time, blood loss and complications were recorded. Results: Among 33 cases, all fractures healed completely without any secondary procedures. No patient had malunion, nonunion, or implant failure. The mean LEFS and knee ROM score at the end of 6 months was 66.27±6.00, and 125.15±7.95 degrees for the affected extremity, the average time of union of fracture was 13.58±1.86 weeks. Average blood loss during surgery was 82.58±12.06 ml and the average radiation time was 84.18±6.77 seconds. 1 (3%) patient had anterior knee pain. Outcomes based on observations are Excellent in 33.3%, good in 48.5%, fair in 18.2%, and Poor in 0%. Conclusion: A tibia diaphyseal fracture treated by IMN through SP leads to better subjective functional outcomes and excellent objective functional outcomes like knee ROM after 6 months.