ORIGINAL RESEARCH article
Front. Surg.
Sec. Orthopedic Surgery
Efficacy Analysis of Suprapatellar Approach Expert Tibial Nail Combined with Plate Internal Fixation for Tibial Shaft Fractures with Concomitant Tibial Plateau Fractures
- RW
Renke Wang 1
- BZ
Bin Zhao 1
- YL
Yue Li 1
- JZ
Jialin Zhang 1
- SQ
Shaodong Qiu 2
1. Ningxia Medical University, Yinchuan, China
2. General Hospital of Ningxia Medical University, Yinchuan, China
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Abstract
Background: Tibial shaft fractures with concomitant tibial plateau fractures are complex injuries resulting from high-energy trauma, posing significant treatment challenges. While plate fixation is common, it is associated with issues like difficult reduction and soft tissue trauma. This study aims to evaluate the clinical efficacy of the suprapatellar approach Expert Tibial Nail (ETN) combined with plate internal fixation for these complex fractures. Methods: A retrospective analysis was conducted on 38 patients with combined tibial shaft and plateau fractures admitted between September 2019 and December 2024. The cohort comprised 21 males and 17 females; age (44.10 ± 12.62) years; time from injury to surgery (5.36 ± 2.35) days. Eighteen patients underwent supracondylar approach Expert Tibial Nailing combined with plate fixation (ETN group), while 20 patients underwent plate fixation alone (Plate group). Data including operative time, intraoperative blood loss, tibial shaft healing time, tibial plateau healing time, knee range of motion at last follow-up, and knee function scores (HSS scores) were recorded and compared between groups. Related complications were also documented. Results: No statistically significant differences were found in baseline characteristics between the two groups (P > 0.05), confirming their comparability. The operative time was significantly longer in the ETN group (108.6 ± 17.60 min) compared to the Plate group (97.30 ± 13.96 min) (P < 0.05). However, the ETN group demonstrated significantly superior outcomes in terms of less intraoperative blood loss, faster tibial shaft healing time, earlier full weight-bearing, greater knee range of motion, and higher HSS knee scores at the final follow-up (all P < 0.05). Conclusion: For tibial shaft fractures with concomitant tibial plateau fractures, the combined approach of suprapatellar ETN and plate fixation is an effective treatment strategy. Despite a longer operative time, it offers advantages over plate-alone fixation, including reduced blood loss, faster fracture healing, earlier weight-bearing, and superior functional recovery of the knee joint.
Summary
Keywords
fracturehealing, intramedullary nailing, suprapatellar approach, tibial plateau fracture, Tibial stem fracture
Received
14 December 2025
Accepted
24 February 2026
Copyright
© 2026 Wang, Zhao, Li, Zhang and Qiu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Shaodong Qiu
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