2026 SICOT Annual Meeting: A comparative study of suprapatellar versus infrapatellar approach for intramedullary nailing of tibial diaphyseal fractures

200 skeletally mature patients with tibial diaphyseal fractures were randomized to undergo intramedullary nailing using either the suprapatellar approach (SPG) (n=100) or infrapatellar approach (IPG) (n=100). The primary outcome of interest was not explicitly specified. Secondary outcomes included operative time, blood loss, fluoroscopy exposure, nail entry accuracy, fracture alignment, anterior knee pain, knee range of motion (ROM), fracture union time, Lysholm score, and complications. The study was conducted between April 2023 and March 2025, although the duration of postoperative follow-up was not reported. Overall, the results revealed that SPG significantly reduced operative time and fluoroscopy exposure while improving fracture alignment, knee ROM, and anterior knee pain compared with IPG. Fracture union times were comparable, with no significant difference in complication rates. These findings suggest that the suprapatellar approach may improve surgical efficiency and functional recovery without compromising fracture healing.