Postural control and torque of the knee joint after healed tibial shaft fracture

Muscular atrophy occurs as a consequence of trauma and immobilisation. This cohort comparison study was conducted to evaluate the limb function after healed tibial shaft fractures, which were treated by casting versus nailing . Balance las centre of pressure) and muscle strength las torque of the kne e joint during knee extension) have been measured in 27 patients with tibia l shaft fractures with a mean age of 39 (19-73) years, 1 year after fractur e healing. Fourteen patients were treated by intramedullary nailing 'nailed group' and 13 by plaster cast with or without minimal internal fixation 'c asted group'. Centre of pressure was measured on a force platform. Knee ext ension torque was measured during isometric and concentric muscle actions b y an isokinetic dynamometer. Centre of pressure tended to be more towards t he uninjured leg in patients who had been treated by plaster cast (P < 0.05 ). Side-to-side differences for isometric torque were significantly higher within the casted group (P < 0.05). Patients with tibial shaft fractures tr eated by intramedullary nailing showed better postural control, one-leg sta nding test, and side-to-side differences for isometric muscle strength comp ared with patients treated by cast. Therefore, we recommend intramedullary nailing as a better method of treatment for tibial shaft fractures, with re gard to recovery of muscle function. (C) 2001 Elsevier Science Ltd. All rig hts reserved.