Comparative clinical outcomes of suprapatellar intramedullary nailing vs. minimally invasive plate osteosynthesis fixation for distal tibial fractures: a retrospective cohort study
By
Bing Song
Qiuxue Zhang
Jize Qian
June 17, 2026
Clinical Scorecard: A Retrospective Cohort Analysis of Suprapatellar Intramedullary Nailing Versus Minimally Invasive Plate Osteosynthesis for Treating Distal Tibial Fractures: Clinical Outcomes Comparison
At a Glance
Category Detail
Condition Distal Tibial Fractures Key Mechanisms Suprapatellar intramedullary nailing (IMN) and minimally invasive plate osteosynthesis (MIPO) Target Population Patients with distal one-third tibial fractures Care Setting Single-center retrospective study
Key Highlights
IMN group had shorter operative time, less blood loss, and smaller incisions (P < 0.001) MIPO group required fewer fluoroscopic exposures (P < 0.001) IMN showed superior functional outcomes at 1 and 3 months (P < 0.05) Time to union was shorter in the IMN group (21.8 ± 2.6 vs. 23.7 ± 2.9 weeks, P = 0.005) Anterior knee pain more common after IMN; incision-related complications more frequent after MIPO Guideline-Based Recommendations
Diagnosis
Distal tibial fractures classified according to established criteria Management
Surgical intervention with either IMN or MIPO based on fracture characteristics and soft tissue condition Monitoring & Follow-up
Assess functional outcomes and complications during a 12–18 month follow-up Risks
Independent risk factors include fracture classification, surgical method, operative time, and BMI Patient & Prescribing Data
70 patients with distal one-third tibial fractures
Surgical strategy should be individualized based on fracture characteristics and patient-specific factors
Clinical Best Practices
Consider IMN for simple extra-articular fractures with satisfactory soft tissue conditions Consider MIPO for fractures with greater metaphyseal instability or alignment control concerns Related Resources & Content
