Treatment options and research progress of proximal tibial extra-articular fractures_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 ZHANG Yuelei ¹ , ZHANG Qi ¹ , LIN Yuan ¹ , FAN Yuandong ²

1. Department of Orthopedics, First Affiliated Hospital of Anhui Medical University, Hefei Anhui, 230000, P. R. China;
2. Shuangdun Central Health Center in Changfeng County, Changfeng Anhui, 231100, P. R. China;

Corresponding?author：

ZHANG Yuelei, Email: orthozhang5233@163.com

Keywords：

Proximal tibial fracture; extra-articular fracture; plate; intramedullary nail; external fixation brace

DOI：

10.7507/1002-1892.202506099

Video：

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Objective To review the main fixation methods for proximal tibial extra-articular fractures based on clinical and biomechanical results, and to provide evidence for clinical application. Methods Extensive related literature at home and abroad was conducted in recent years, and external fixation systems such as external fixation braces and external locking plates, as well as internal fixation systems such as plates and intramedullary nails, were systematically reviewed regarding their application indications, clinical efficacy, and biomechanical results in proximal tibial extra-articular fractures. Results External fixation systems have advantages in fractures with open or severe soft tissue injury, facilitating wound management and maintaining stability of the fracture site to some extent. However, in proximal tibial extra-articular fractures with good soft tissue conditions, internal fixation systems such as plates and intramedullary nails are still the first choice. Some studies have found that intramedullary nails allow patients to bear weight early, with shorter fracture healing time and higher rate of malunion, while other studies have found that both intramedullary nails and plates have similar clinical efficacy and can achieve satisfactory treatment results. Conclusion The choice of fixation method for proximal tibial extra-articular fractures depends not only on the type of fracture, but also on the surgeon’s habits and operational skills. Larger-scale studies are still needed to clarify the advantages and disadvantages of intramedullary nails and locking plates in the treatment of proximal tibial extra-articular fractures.

Citation： ZHANG Yuelei, ZHANG Qi, LIN Yuan, FAN Yuandong. Treatment options and research progress of proximal tibial extra-articular fractures. Chinese Journal of Reparative and Reconstructive Surgery, 2025, 39(11): 1485-1490. doi: 10.7507/1002-1892.202506099 Copy

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1. Ren C, Li M, Sun L, et al. Comparison of intramedullary nailing fixation and percutaneous locked plating fixation for the treatment of proximal tibial fractures: A meta-analysis. J Orthop Surg (Hong Kong), 2021, 29(2): 23094990211024395. doi: 10.1177/23094990211024395.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12. Craig A, Barron E, Sharma H, et al. Do patients achieve “full weight-bearing” immediately following application of circular frame fixation of the lower limb? Strategies Trauma Limb Reconstr, 2024, 19(1): 40-44.
13.
14. Bove F, Sala F, Capitani P, et al. Treatment of fractures of the tibial plateau (Schatzker Ⅵ) with external fixators versus plate osteosynthesis. Injury, 2018, 49 Suppl 3: S12-S18.
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23.
24.
25.
26.
27.
28.
29.
30.
31.
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33. Pulley BR, Gardner MJ. Bridge plating of proximal tibial metaphyseal fracture by limited open technique. J Orthop Trauma, 2019, 33 Suppl 1: S34-S35.
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40. Rayes J, Willms S, Buckley R. Proximal to midshaft closed tibial fracture-Infra or supra-patellar nailing? Injury, 2022, 53(10): 3067-3069.
41. Ciminero M, Elsevier H, Solarczyk J, et al. Suprapatellar tibial nailing: Future or fad? J Clin Med, 2023, 12(5): 1796. doi: 10.3390/jcm12051796.
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45.
46.
47.
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Chinese Journal of Reparative and Reconstructive Surgery

Treatment options and research progress of proximal tibial extra-articular fractures

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