Comparative study of early versus delayed postoperative weight-bearing after intramedullary nail fixation of tibia fracture
Lu Hongxin, Chen Xiaotian, Ye Longfei, Wang Xiaopan, Wu Min, Dai Xiusong, Xiao Yuzhou
Department of Orthopedics, the First Affiliated Hospital of Bengbu Medical College, Laboratory of Tissue and Transplant in Anhui Province, Bengbu 233004, China
Abstract：Objective This study was performed to investigate the clinical effect of intramedullary nail in the treatment of early and late postoperative weight-bearing patients with tibial fractures. Methods Retrospective analysis included 107 patients with tibial fractures from the Department of Orthopedics of the First Affiliated Hospital of Bengbu Medical College from January 2017 to December 2020. The cohort included 75 males and 32 females, aged 18-77 (39.9±10.9) years. All patients were treated with intramedullary nail fixation and divided into two groups according to the starting time of the weight-bearing of the affected limb after operation. The early weight-bearing group had partial-weightbearing of the affected limb within 4 weeks after operation, and the late negative recombination group had no weight-bearing of affected limb within 4 weeks after operation. Baseline data, operation time, diameter of the intramedullary nail, failure rate of implant materials, Lysholm score of knee joint function at 3 months after operation, and fracture healing at 6 months and 1 year after operation were compared. Results No statistical difference was found between the two groups in the general data, such as age, body mass index, tibial fracture location, classification, anesthesia grade, injury mechanism, whether open or fibular fracture, and external fixator (all P values >0.05). No significant difference was found between the two groups in the perioperative indicators, such as operation time and diameter of intramedullary nail (all P values >0.05). No implant failure occurred in the early weight-bearing group compared with one implant failure (1.21%, 1/82) in the no-weight-bearing group. Delayed bone union at six months occurred in 4 (16.0%, 4/25) patients in the early weight-bearing group against 24 (29.3%, 24/82) patients in the no-weight-bearing group. Delayed bone union at one year occurred in one (4.0%, 1/25) patient in the early weight-bearing group against 9 (11.0%, 9/82) patients in the no-weight-bearing group. These results had no significant differences (all P values >0.05). The knee joint function score (88.0±2.4) of the early weight-bearing group was higher than that of the late weight-bearing group (74.5±4.6), with statistically significant difference (t=19.32, P<0.001). Conclusion Early weight-bearing within 4 weeks after intramedullary nail fixation of the tibia fracture can improve the joint function of the affected limb. This phenomenon has a good clinical effect and is worthy of further promotion.
卢红信, 陈笑天, 叶龙飞, 王晓盼, 吴敏, 代秀松, 肖玉周. 胫骨骨折髓内钉内固定患者术后早期与晚期负重的对比研究[J]. 中华解剖与临床杂志, 2022, 27(8): 563-567.
Lu Hongxin, Chen Xiaotian, Ye Longfei, Wang Xiaopan, Wu Min, Dai Xiusong, Xiao Yuzhou. Comparative study of early versus delayed postoperative weight-bearing after intramedullary nail fixation of tibia fracture. Chinese Journal of Anatomy and Clinics, 2022, 27(8): 563-567.
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2022, Vol. 27 
