Outcomes of Extra-Articular Proximal and Distal Third Tibial Fractures in Adults Treated Using Multidirectional Tibial Nail

Background: Extra-articular fractures of the proximal and distal thirds of the tibia represent a challenging subset of tibial shaft fractures due to the metaphyseal anatomy and deforming muscular forces that predispose these fractures to malalignment. Intramedullary interlocking nails with multidirectional locking options have been introduced to improve fixation stability and alignment in such fractures. Aim: To evaluate the clinical, radiological, and functional outcomes of extra-articular proximal and distal third tibial fractures in adults treated using multidirectional tibial nailing. Methodology: A prospective observational study was conducted on 40 adult patients with extra-articular proximal or distal third tibial fractures treated with multidirectional tibial nailing. Patients were followed for 12 months postoperatively. Clinical outcomes were assessed using the Johner-Wruhs criteria, and radiological union was assessed on serial radiographs. Results: The mean age of patients was 36.8 ± 12.5 years. The average time to radiological union was 19.8 weeks. Excellent or good functional outcomes were observed in 80% of patients. Complications included superficial infection (5%), anterior knee pain (10%), and malalignment (7.5%). Conclusion: Multidirectional tibial nailing provides stable fixation and favourable functional outcomes in extraarticular proximal and distal tibial fractures. The technique minimizes soft tissue damage and allows early mobilization with a low complication rate.