SynthesisEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2022
Outcomes of early versus delayed weight-bearing with intramedullary nailing of tibial shaft fractures: a systematic review and meta-analysis.
Synthesis in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Effect of early weight bearing program with conventional physiotherapy on functional outcomes in surgically treated proximal tibia fracture: a pilot randomized controlled trial.Archives of orthopaedic and trauma surgery · 2024Trial
- Identification of biomechanical alterations associated with nonunion after tibial shaft fractures using musculoskeletal simulation based on motion capture and instrumented insole data.Archives of orthopaedic and trauma surgery · 2026Article
- Risk factors for delayed healing after traumatic limb fractures and a comparative assessment of external versus internal fixation in delayed union.American journal of translational research · 2026Article
- Interventions for treating tibial shaft fractures in children.The Cochrane database of systematic reviews · 2025Article
- [Sensor-based monitoring of fracture healing].Unfallchirurgie (Heidelberg, Germany) · 2025Article
- Immediate versus delayed weight bearing for fractures of the pelvis, acetabulum, distal femur, and proximal and distal tibia: a feasibility randomized controlled trial.Pilot and feasibility studies · 2025Article
- Immediate full weightbearing with additive cerclage improves early mobility after tibial shaft spiral fractures.Scientific reports · 2025Article
- Factors associated with decline in ambulatory ability following intramedullary nailing of 42A-C diaphyseal tibia fractures.Journal of clinical orthopaedics and trauma · 2025Article
- Weight-Bearing Versus Non-Weight-Bearing After Ankle Fracture: A Systematic Review and Meta-Analysis of Patient-Reported Outcome.Life (Basel, Switzerland) · 2025Review
- Causal Link between Gut Microbiota, Neurophysiological States, and Bone Diseases: A Comprehensive Mendelian Randomization Study.Nutrients · 2023Article
Corrections and comments
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeEarly weight bearing (EWB) is often recommended after intramedullary nailing of tibial shaft fractures, however, the risks and benefits have not been critically evaluated in a systematic review or meta-analysis. Therefore, the aims of this study were to perform a systematic review and meta-analysis comparing EWB and delayed weight-bearing (DWB) after intramedullary nailing of tibial shaft fractures and assess the relationship between weight-bearing, fracture union and healing.
methodThis review included studies comparing the effects of EWB, defined as weight-bearing before 6 weeks, and DWB on fracture union and healing. PubMed, Embase, CINAHL, and the Cochrane Library were searched from inception to 9 May 2021. Risk of bias was assessed using the Down's and Black Checklist and Cochrane Risk of Bias Tool 2.0. Data were synthesised in a meta-analysis, as well as narrative and tabular synthesis.
resultsEight studies were included for data extraction and meta-analysis. The analysis produced mixed results and found a significant decrease in mean union time (-2.41 weeks, 95% confidence interval: -4.77, -0.05) with EWB and a significant Odd's Ratio (OR) for complications with DWB (OR: 2.93, 95% CI: 1.40, 6.16). There was no significant difference in rates of delayed union, non-union, re-operation and malunion.
conclusionThe included studies were of moderate risk of bias and demonstrated shorter union time and fewer complications with EWB. However, current evidence is minimal and has significant limitations. The role of EWB in high-risk patients is yet to be examined. Further well-designed, randomised studies are required on the topic.
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