TIBIAL EXTERNAL FIXATION, WEIGHT-BEARING, AND FRACTURE MOVEMENT

Axial fracture movement and loading has been measured during weight be aring in 45 patients with tibial diaphyseal fractures treated with uni lateral external skeletal fixation. Mean axial fracture displacement r eached a maximum of 0.6 mm between seven and 12 weeks postfracture. Ve ry little movement occurred during the first five weeks after fracture . A micromovement module attached to the fixator increased axial movem ent at the fracture site by 50% during walking. Weight bearing reached 75% of mean body weight by ten weeks after the fracture. Weight beari ng was not decreased by any biofeedback mechanism. A randomized prospe ctive clinical study of diaphyseal tibial fractures treated with exter nal fixation showed a significant reduction in time to healing when mi cromovement was imposed. Controlled fracture site movement can be impo sed very early after fixator frame application when mechanical stimula tion may be most effective, and the active loading by the patient is l east.