The clinical, functional and radiological union among the cases of complex proximal and distal tibial fractures, managed by nailing in supra-patellar approach.

Tibial diaphysis is the most common site of fracture in the tibia and about 80% of these injuries are associated with fibular fractures. Surgically, intramedullary nail fixation remains the treatment of choice for displaced and un-displaced tibial shaft fractures in adult population. Supra-patellar nailing in the semi extended position has recently been suggested as a safe and effective surgical technique. All these patients were clinically and radiologically confirmed with proximal and distal tibial fractures, and were eligible for the study. After carrying out necessary laboratory investigations and obtaining physical fitness for surgery, the subjects were surgical managed with expert tibial nailing through suprapatellar approach. The mean VAS, 1 month after surgery was 5.03±1.10, which got significantly reduced to 1.70±0.84 and 0.43±0.50 at 3 and 6 months after surgery. The mean duration required for healing of wounds was 11.87±1.72 days. The radiological union was observed in 90.0% at 6 months and in 100.0% at 12 months, and also the suprapatellar approach was successful in significantly improving the radiological outcome in a short period of time. Delayed union was the only complication observed in 3 individuals. There was statistically significant relation only in terms of age and interval between injury and surgery, thereby suggesting that younger the age of the subjects, earlier the surgery after injury, better was the functional outcome. [ABSTRACT FROM AUTHOR]