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

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.

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.

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.

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.

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not relevant.