Heliyon
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Whether the optimal treatment for tibial shaft fractures is suprapatellar intramedullary nailing or infrapatellar approach is controversial. ⋯ Suprapatellar intramedullary nailing reduced the incidence of knee pain and the average malalignment of fractures compared to infrapatellar intramedullary nailing. It also reduced the operation time and fluoroscopy time. The results of the study should be interpreted with caution due to the heterogeneity of the study designs.