Efficacy analysis of suprapatellar approach expert tibial nail combined with plate internal fixation for tibial shaft fractures involving the tibial plateau

Combined tibial plateau and ipsilateral tibial shaft fractures are relatively uncommon, presenting complex injury mechanisms and significant treatment challenges. Many clinicians opt for plate fixation, though this approach involves substantial trauma and a high risk of postoperative complications. Intramedullary nails effectively address issues like excessive trauma and blood loss, but they provide inadequate support for the tibial plateau. This study employed combined plate and intramedullary nail fixation for tibial plateau fractures with concomitant ipsilateral tibial shaft fractures to evaluate the clinical efficacy of this approach. Results demonstrated significant advantages of intramedullary nails combined with plates over plate fixation alone in terms of operative time, intraoperative blood loss, tibial shaft fracture healing time, knee range of motion, and knee function scores at the final follow-up. Finally, this paper discusses the stability, biomechanical characteristics, and surgical sequence of the combined intramedullary nail and plate approach, aiming to provide new treatment insights for this fracture type.