Functional Outcomes of Tibia Fractures Treated With Intramedullary Interlocking Nails by Suprapatellar Approach: A Prospective Study.

Abstract

Background Tibia fractures are the most common lower extremity fractures. The subcutaneous anatomy of this long bone predisposes it to high fracture frequency in a high-energy trauma. The tibia is a major weight-bearing, long tubular bone that is axially and rotationally unstable when fractured, which ideally necessitates its surgical fixation in adults. Tibia fractures can be treated with a variety of choice of implants and surgical approaches. This study aims to assess the clinical and functional outcomes of a tibia fracture treated with intramedullary interlocking nails by a suprapatellar approach. Methodology A total of 32 patients were selected from patients admitted at Shri B. M. Patil Medical College and Research Centre with tibia fractures between January 2021 and May 2022. All the patients were treated with closed reduction and internal fixation with intramedullary interlocking nails by suprapatellar approach with a semi-extended knee position. Allpatients were followed up clinically and radiologically at regular intervals of six weeks, three months, six months, and one year. All functional outcomes were assessed based on modified Lysholm knee scores. Results A total of 31 patients showed union at the fracture site. One patient had nonunion and implant failure at the distal locking site, and two patients had persistent anterior knee pain at the end of one year. Functional outcome assessment based on modified Lysholm scores had excellent results, with a mean score of 95. Patients were followed up for a mean of 11.5 months. The mean time of union was observed as 12.5 months. Conclusions Suprapatellar tibia nailing is an effective alternative approach with ease of reduction and decreased intraoperative fluoroscopy time. The entry is in line with the medullary cavity preventing malreduction of proximal and distal tibia fractures. The additional proximal locking option also increases the stability of implant fixation.