Faculty Collaboration Database

Gait and strength assessment following surgical repair by intramedullary nailing of isolated tibial shaft fracture. J Orthop Res 2024 Mar;42(3):618-627

Date

10/07/2023

Pubmed ID

37804214

DOI

10.1002/jor.25704

Scopus ID

2-s2.0-85174251460 (requires institutional sign-in at Scopus site)   5 Citations

Abstract

The objective of the study was to evaluate the long-term strength and gait outcomes after intramedullary nailing of isolated tibial diaphyseal fractures. This retrospective cohort study was conducted at an academic Level I trauma center. Fifteen participants with isolated tibial diaphyseal fractures (OTA/AO 42) at least 2 years postoperative from intramedullary nailing (IMN) provided informed consent. The average age was 40 ± 14 (range, 24-69); there were nine men and six women. Knee flexion-extension strength data were collected. Temporal-spatial, kinematic, and kinetic gait parameters were measured and compared to historic control data. Participants completed the SF-36 and shortened musculoskeletal function assessment questionnaires. The mean length of follow-up between surgery and gait analysis was 6 ± 2 years. The fractured limb demonstrated deficits in quadriceps strength between 9.8% and 23.4% compared to the unaffected limb. Temporal-spatial parameters revealed slower walking speed, shorter stride length, decreased cadence, and shorter single-limb support time in the fractured limb. Altered kinematic and kinetic findings included a knee extension shift during stance, with an increased knee flexor moment demand and decreased total knee power during loading and midstance. These findings represent deficits in concentric and eccentric knee extensor activity. Additionally, the fractured limb demonstrated decreased ankle dorsiflexion during stance and diminished ankle push-off power. Long-term outcomes after IMN of tibial diaphyseal fractures demonstrate decreased quadriceps strength and altered gait parameters that may have implications to the high incidence of knee and ankle pain in the fractured limb.

Author List

Canseco K, Becker BM, Muscott RK, Schmeling GJ, Fritz JM

Authors

Jessica M. Fritz PhD Associate Professor in the Orthopaedic Surgery department at Medical College of Wisconsin
Greg J. Schmeling MD Vice Chair, Professor in the Orthopaedic Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Female
Fracture Fixation, Intramedullary
Gait
Humans
Knee
Male
Middle Aged
Retrospective Studies
Tibial Fractures
Treatment Outcome