Early weight bearing after diaphyseal tibial fracture: A cohort analysis of 172 surgically treated diaphyseal tibialfractures in a level-I trauma center

Houben, I. (Ignas) (2016) Early weight bearing after diaphyseal tibial fracture: A cohort analysis of 172 surgically treated diaphyseal tibialfractures in a level-I trauma center. thesis, Medicine.

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Abstract

Introduction: Despite many surgical developments, long bone fracture healing still shows a high failure rate, especially in tibial fractures. We know weight bearing can stimulate fracture healing and former studies suggest weight bearing is safe immediately after fracture fixation. Until now, clinical application of this knowledge seems sparse. We hypothesized early weight bearing has a positive influence on fracture healing. Also, we aimed to study the patient’s compliance to the doctor’s rehabilitation advice. Methods: In a cohort study data was collected on all surgically treated diaphyseal tibial fractures at a level-I trauma center between January 2007 and March 2015. The timing of initial weight bearing (IWB) was analyzed as a predictor for impaired healing (non-union after six months) in a multivariate logistic regression. Multivariate linear regression analysis was used for the comparison between the doctor’s postoperative rehabilitation advice and actual IWB. Results: 172 diaphyseal tibial fractures were included, 92 cases with impaired healing and 80 controls with normal healing. The mean age was 38.4 years (range 16-89). The mean time until IWB in the normal fracture healing group was 21.4 days and 52.8 days in the impaired fracture healing group. The odds ratio (OR) of developing impaired healing versus normal healing was 1.12 per week (95% C.I. 1.02-1.23). A significant correlation between doctor’s restrictions in weight bearing and later IWB was found, independent of correction for possible confounding factors. Discussion: Early IWB has a significant predictive value on the likelihood of developing normal fracture healing. Although the OR (1.12) appears to be small, it accounts for an OR per week of weight bearing restriction. The decision for timing of weight bearing can be influenced, in contrast to the fracture type for instance. Patients appear to be compliant in clinical setting towards the doctor’s rehabilitation advice.

Item Type:	Thesis (Thesis)
Supervisor name:	Facultair begeleider: and Roerdink, dr. W.H.
Supervisor name:	Plaatselijk begeleider: and Blokhuis, dr. T.J. and Instelling: Universitair Medisch Centrum Utrecht
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:41
Last Modified:	25 Jun 2020 10:41
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/249

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