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Abstract Background: Tibial shaft fractures occur due to several causes as car accidents and sports injuries.There are several surgical treatment options of tibial shaft fractures, including interlocking nails and plates.Aim: To assess the clinical and radiological results of comminuted midshaft fractures of the tibia treated with interlocking nails and plates using finite element analysis.Methods: This is a retrospective study that was conducted on patients with comminuted fractures of the midshaft of the tibia at the Orthopedic Department of Aseer Central Hospital, Saudi Arabia. Finite element analysis was used, and the collected data were analyzed using the SPSS program.Results: The study included 22 patients, with a mean ± SD age of 28.4 ± 8.3 years old.The majority of patients were males 18 (81.8%).The major surgery performed for patients was fixation using interlocking nails 16 (72.7%). A significant negative correlation was found between age and bending (r = -0.423, P = 0.05). There were significant differences between titanium and stainless-steel materials in bending (P=0.041), and strain percent (P = 0.017) after applying load indicating that titanium was superior to stainless steel. When comparing interlocking nails and plates after load application, there was also a significant difference in both bending (P=0.041) and strain percent (P=0.017), reflecting that interlocking nails were superior to plates |