Immediate weight-bearing after osteosynthesis of proximal tibial fractures may be allowed.

Abstract

INTRODUCTION: Immediate weight-bearing following osteosynthesis of proximal tibial fractures is traditionally not allowed due to fear of articular fracture collapse. Anatomically shaped locking plates with sub-articular screws could improve stability and allow greater loading forces. The purpose of this study was to investigate if immediate weight-bearing can be allowed following locking plate osteosynthesis of proximal tibial fractures. MATERIAL AND METHODS: Locking plate osteosynthesis of partial articular proximal tibial fractures (Arbeitsgemeinschaft für Osteosynthesefragen type 41B) operated from November 2007 to September 2009 at Hvidovre Hospital were included retrospectively (n = 32). Complications, reoperations and radiographic outcome at 6-8 week of follow-up were assessed. Twenty patients were not allowed to bear weight the first 6-8 weeks, whereas twelve were allowed immediate postoperative weight-bearing. RESULTS: The use of bone allograft, the number of screws inserted and the application of postoperative articular mobilizing brace were comparable between the two groups (p = 0.08). Persisting depressions of the articular surface ranged from 0 to 5 mm postoperatively with no difference between the groups (p = 0.36). At 6-8 weeks postoperatively, no changes in radiographic configuration of the fracture site were observed in either group. CONCLUSION: This retrospective study suggests that immediate weight-bearing following locking plate osteosynthesis of partial articular proximal tibial fractures may be allowed. Future, larger prospective randomised studies are needed. FUNDING: not relevant. TRIAL REGISTRATION: not relevant.