• Sumin Lim, Hyung Keun Song, Tae Hun Kim, Do Young Park, LeeJong WhaJWDepartment of Orthopedic Surgery, School of Medicine, Ajou University, 164 Worldcup-ro, Yongtong-gu, Suwon, 16499, Korea., and Jun Young Chung.
• Department of Orthopedic Surgery, School of Medicine, Ajou University, 164 Worldcup-ro, Yongtong-gu, Suwon, 16499, Korea.
• Arch Orthop Trauma Surg. 2023 Dec 1; 143 (12): 700970177009-7017.

PurposeTo compare the radiological alignment, union time, union rate, and complication rate between suprapatellar intramedullary nails and minimally invasive locking plate fixation in the treatment of proximal tibial fractures.Materials And MethodsWe retrospectively analyzed 103 patients who underwent plate fixation (n = 50) or suprapatellar intramedullary nailing (n = 53) for proximal tibial fractures involving the meta-diaphyseal junction between November 2015 and October 2020 at our institution. The union rate, union time, radiologic alignments, and complications, such as malalignment, nonunion, and deep infection, were investigated.ResultsThe demographic data did not differ between the plate and suprapatellar intramedullary nail groups. The alignment of the coronal plane was 0.24 ± 3.19 in the plate group and - 0.49 ± 2.22 in the intramedullary nail group (p = 0.196). Sagittal plane alignment was - 0.29 ± 4.97 in the plate group and 0.24 ± 4.12 in the intramedullary nail group (p = 0.571), and coronal malalignment (p = 0.196), sagittal malalignment (p = 0.57), deep infection (p = 0.264), nonunion (p = 0.695), union time (p = 0.329), and final union rate (p = 0.699) were not significantly different between groups.ConclusionCompared with the minimally invasive locking compression plate group, the suprapatellar intramedullary nail group yielded comparable results in terms of radiological alignment and complications. Considering that proximal tibial fractures are associated with high-energy trauma and severe soft tissue damage, we believe that a suprapatellar intramedullary nail may be a good alternative.Level Of EvidenceLevel III.© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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