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. 2023 Jan 1;37(1):38-43.
doi: 10.1097/BOT.0000000000002451.

Immediate Weight Bearing as Tolerated Is Safe Following Intramedullary Fixation of Extra-articular Metaphyseal Proximal Tibia Fractures (OTA/AO 41-A)

Zachary L Telgheder  1 , Brenton Hill, Kevin Huang, David T Watson, Benjamin Maxson, Anthony Infante, David Donohue, Anjan Shah, Katheryne Downes, Roy W Sanders, Hassan R Mir
Affiliations

Immediate Weight Bearing as Tolerated Is Safe Following Intramedullary Fixation of Extra-articular Metaphyseal Proximal Tibia Fractures (OTA/AO 41-A)

Zachary L Telgheder et al. J Orthop Trauma. .

Abstract

Objectives: To determine whether immediate weight bearing after intramedullary fixation of extra-articular proximal tibia fractures (OTA/AO 41A) results in change of alignment before union.

Design: Retrospective Review.

Setting: Level I and Level II Trauma Center.

Patients/participants: Thirty-seven patients with 37 proximal tibial fractures, all whom could bear weight as tolerated postoperatively. Eighteen fractures were OTA/AO 41-A2, and 19 were OTA/AO 41-A3.

Intervention: Intramedullary nailing of extra-articular proximal tibia fractures.

Main outcome measurements: Change in fracture alignment or loss of reduction.

Results: The average change in coronal alignment at the final follow-up was 1.22 ± 1.28 degrees of valgus and 1.03 ± 1.05 degrees of extension in the sagittal plane. Twenty-five patients demonstrated excellent initial alignment, 10 patients demonstrated acceptable initial alignment, and 2 patients demonstrated poor initial alignment. Five patients demonstrated a change in alignment from excellent to acceptable at the final follow-up. No patient went from excellent or acceptable initial alignment to poor final alignment. Five patients required unplanned secondary surgical procedures. Two patients required return to the operating room for soft-tissue coverage procedures, 2 patients required surgical debridement of a postoperative infection, and 1 patient underwent debridement and exchange nailing of an infected nonunion. No patient underwent revision for implant failure or loss of reduction.

Conclusion: Immediate weight bearing after intramedullary fixation of extra-articular proximal tibia fractures (OTA/AO 41A) led to minimal change in alignment at final postoperative radiographs.

Level of evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

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Conflict of interest statement

The authors report no conflict of interest.

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