Early weight bearing after complete tibial shaft fractures in children

This study determined the prevalence of complications related to early weight bearing and the factors associated with time to healing in children after a complete tibial shaft fracture. Radiographs and medical records were reviewed from patients with unilateral, closed, complete tibial shaft fractures who were treated nonoperatively with a long leg cast. There were 55 males (68.8%) and 25 females (31.2%) with a mean ± SD age of 6.0 ± 4.0 years (range 1-16). There were few complications (2.5%) and patients healed faster if they bore weight earlier (0.3 days faster for each day earlier to weight bearing, P = 0.02), were younger (2.3 days faster per year younger, P < 0.001), were female (2.7 days faster than males, P = 0.02), or did not have a closed reduction (3.8 days faster, P = 0.002) (R = 0.63). Time to weight bearing after complete tibial shaft fracture was not associated with an increased risk of complications. Earlier weight bearing was associated with a shorter time to healing. This study provides support for treatment with early weight bearing in children with closed, complete tibial shaft fractures.