Digital monitoring of weight-bearing improves success rates and reduces complications in lower extremity surgeries

Abstract

The aim of this study is to develop a digital monitoring system to track weight and evaluate its impact on postoperative outcomes after lower extremity surgeries (LES). This parallel randomized controlled trial enrolled 266 patients who underwent LES (fracture or joint replacement) at our medical center between March 11, 2022, and January 10, 2023. Patients were randomly assigned to the intervention and control groups in a 1:1 ratio. The intervention group (n=116) used a cane and shoes equipped with a weight-bearing system after lower limb surgery, while the control group (n=116) used a simple cane and shoes without a weight-bearing system. The primary outcomes included callus formation, duration of union, and success rate of union in the two groups. The intervention group had a significantly higher rate of complete surgical success than the control group (93.9% vs. 79.3%, p=0.001). The intervention group also had a significantly lower risk of non-union than the control group (OR: 2.33, 95% CI: 1.14, 3.48, p=0.001). The mean duration of surgery until the time of union and the meantime of callus formation was significantly lower in the intervention group (p=0.01). The use of a digital monitoring system for weighing in LES significantly increased the success rate and reduced post-operative complications. Therefore, incorporating this system can enhance the rehabilitation process and prevent revision surgeries in patients with LES.

The Impact of Delayed Osteosynthesis of Bone Healing in Patients with Extra-articular Distal Femoral Fracture

“…Cytokines play an important role in fracture healing because almost 60 hours after fracture, inflammation and angiogenesis factors are expressed differently, as well as cellular composition in fractures with normal healing process versus fractures terminating in nonunion ( 14 , 20 ). An analysis of inflammatory, angiogenic, and osteogenic factors in the hematoma 4 and 7 days after the start of bone repair reveals that these factors change over time and mechanically induced delayed union affects them clearly ( 21 - 23 ). Therefore, it can be concluded that the age of the hematoma plays an important role in bone healing, and impairing the natural course of this process affects the outcomes of fracture.…”

“…Various studies have been performed on the role of initial fracture hematoma in bone healing both in human and animal models. Most of these studies have demonstrated differential expression of a variety of bone healing factors in hematoma of the compromised bone-healing situation compared to normal bone-healing ( 7 , 11 , 21 , 22 , 23 ). However, the impact of delayed osteosynthesis on the outcome of bone healing has been scarcely evaluated.…”