Clinical and Radiological Outcome in Proximal Tibial Diaphyseal Fracture Managed by Suprapatellar Nailing Technique: A Prospective Cohort Study

Background: There are certain factors that make proximal tibia fractures difficult to align and recover from the fracture site despite being in the setting of high energy trauma. The suprapatellar approach for intramedullary nailing has emerged as a technique that may improve fracture reduction and early rehabilitation outcomes. The objective is to evaluate the clinical and radiological outcomes of proximal tibial diaphyseal fractures managed with suprapatellar intramedullary nailing at 6, 12, and 24 weeks after the treatment of proximal tibial diaphyseal fracture with suprapatellar intramedullary nailing, and to evaluate the functional outcome at same time points using Lysholm knee score, VAS, range of motion and radiological parameters. Material and Methods: A prospective cohort study was conducted on 81 patients with extra-articular proximal tibial diaphyseal fractures treated with suprapatellar intramedullary nailing over one year. Clinical and radiological assessments were performed at predefined follow-ups (2, 6, 12, and 24 weeks). Outcome measures included VAS, Lysholm score, knee range of motion, radiological union, and alignment. Statistical analysis was performed using SPSS version 23.0, with p < 0.05 considered significant. Results: The mean VAS score reduced from 8.25 ± 0.643 at admission to 0.395 ± 0.492 at 24 weeks. Functional outcomes improved significantly, with mean Lysholm scores increasing to 90.346 ± 3.779 at final follow-up. Progressive improvement in knee range of motion was observed, and all patients achieved full weight bearing by 12 weeks. Radiological evaluation demonstrated maintained alignment within acceptable limits and complete cortical bridging in all patients at 24 weeks, indicating successful fracture union. No early postoperative complications were reported. Conclusion: Suprapatellar intramedullary nailing is a safe and effective technique for managing proximal tibial diaphyseal fractures, providing reliable alignment, early functional recovery, and excellent radiological union.

Keywords: Proximal tibial fracture, Suprapatellar nailing, Intramedullary nailing, Functional outcome, Radiological union, Lysholm score.