Aims and objective: Fractures of tibia shaft are most common of long bone fractures. Proximal tibia fractures account for approximately 5% to 11% of all tibial injuries and affect knee function and stability in most of the cases. Higher rates of malunion and increased incidence of associated complications have made these fractures particularly problematic. This study was performed to compare functional outcome and duration of union of metaphyses diaphyseal fractures of tibia treated with Multidirectional Interlocking Intramedullary Nailing (ETN: Expert Tibia Nail) and Locking Compression Plating and achieve Restoration of axis, length, and rotation of the lower leg; Sufficient primary stability of the osteosynthesis for early functional aftercare to maintain joint mobility.

Methodology: We conducted a prospective study to know which definitive surgical treatment option (nailing or plating) is better for extra-articular proximal tibia fracture. Subjects who have sustained proximal tibia extra-articular fracture and who are admitted in Apollo Institute of Medical Sciences and Research, Chittoor were the sources. The Sample Size is 30. With 15 in each group (group A Plating and group B Nailing). The functional outcome was assessed using Klemm Borner Knee Scoring system during clinical follow-up at 6 weeks, 3 months and at 6 months post-surgery.

Results: Both Groups showed no significant difference in functional outcome assessed using Klemm Borner score, Klemm borner score in both groups initially at 6 weeks showed 26.7% good results in plating group and 33.3% good results in nailing group which progressed to give 60% excellent results in both groups and 26.7% good results in plating group and 33.3% in nailing group. Post-operative hospital stay (p = 0.043), postoperative infection rate (p = 0.036) were significantly high in the PTLCP group than in the IMN group, while rate of malunion (p=0.041) and non-union (0.037) were significantly high in IMN group than in PTLCP group. However there was no clear advantage of either technique in terms of functional recovery of knee.

Conclusion: Present comparison of IMN and MIPPO for the treatment of proximal one-third tibia fracture showed no clear advantage of either technique. Present study concluded that both forms of treatment (IMN and MIPPO) provide adequate fracture stability. Journal of Orthopedic Education 64 Volume 9 Number 1, January-April 2023 Considering lesser time for union, early weight bearing, lower chances of infection and lesser surgical duration, nailing seems to be more promising for extra articular proximal tibia fractures but Locking Compression Plating provides stable reduction in fractures like (AO41A2.2- simple metaphysical oblique fracture in sagittal plane)