Singh AK, Sait S, Khan Y, et al. - The present study was conducted to analyze functional outcome, at medium-term follow up, in patients undergoing intra-medullary nailing of tibial shaft fractures, applying the supra-patellar approach. Between March 2013 to August 2015, this research included patients with intra-medullary nailing, for diaphysial tibia fractures. Researchers reviewed a larger cohort of 22 patients with supra-patellar nailing for medium term assessment of their functional outcomes at average 60 months (50 – 78 months) and compared the results between all 3 groups. The Kujala and Oxford Knee Scores were applied to assess all patients. This study's findings imply that compared with traditional infra-patellar nailing, patients undergoing supra-patellar tibial nailing have better outcomes at 15 months and more importantly, they continue to do well even at 5 years, despite perceived risks correlated with this method.