Effect of weight-bearing on healing of cortical defects in the canine tibia.

Meadows, TH; Bronk, James T.; Chao, Yan; Kelly, PJ

doi:10.2106/00004623-199072070-00018

Cited by 81 publications

(34 citation statements)

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“…Early weight-bearing is associated with increased bone formation. [23][24][25] We noted that delay in full weight-bearing was linked with a higher incidence of nonunion. This is, however, difficult to analyse retrospectively since the pain associated with failure of union will lead to a delay in weight-bearing and an increased requirement for analgesia.…”

Section: Discussionmentioning

confidence: 96%

Nonunion of the femoral diaphysis

Giannoudis¹,

MacDonald²,

Matthews³

et al. 2000

The Journal of Bone and Joint Surgery. British volume

150

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We assessed factors which may affect union in 32 patients with nonunion of a fracture of the diaphysis of the femur and 67 comparable patients whose fracture had united. These included gender, age, smoking habit, the use of non-steroidal anti-inflammatory drugs (NSAIDs) the type of fracture (AO classification), soft-tissue injury (open or closed), the type of nail, the mode of locking, reaming v non-reaming, infection, failure of the implant, distraction at the fracture site, and the time to full weight-bearing. Patients with severe head injuries were excluded. Both groups were comparable with regard to gender, Injury Severity Score and soft-tissue injury.There was no relationship between the rate of union and the type of implant, mode of locking, reaming, distraction or smoking. There were fewer cases of nonunion in more comminuted fractures (type C) and in patients who were able to bear weight early. There was a marked association between nonunion and the use of NSAIDs after injury (p = 0.000001) and delayed healing was noted in patients who took NSAIDs and whose fractures had united.

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Section: Discussionmentioning

confidence: 96%

Nonunion of the femoral diaphysis

Giannoudis¹,

MacDonald²,

Matthews³

et al. 2000

The Journal of Bone and Joint Surgery. British volume

150

View full text Add to dashboard Cite

show abstract

“…Weight bearing has been widely used to promote fracture healing. Although several clinical and experimental studies, usually on tibia, have supported this view (Sarmiento et al 1977, DeLee et al 1981, Meadows et al 1990, Richardson et al 1995, some orthopedists still doubt that it is true (Riggins et al 1985, Wu andShih 1992). Dynamization of static interlocking nails in complex tibia1 fractures was successful in two thirds of the cases, but only in half of the cases of complex femoral fractures .…”

Section: Discussionmentioning

confidence: 99%

Healing of 56 segmental femoral shaft fractures after locked nailing: Poor results of dynamization

Chen

1997

Acta Orthopaedica Scandinavica

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“…Overloading can affect healing time and the stability or integrity of the healing structure (Pauser et al, 2012), however underloading can also be detrimental as adequate weight bearing encourages the healing process, for example osteoblastic stimulation (Meadows, Bronk, Chao & Kelly, 1990). Therefore accurate reproducibility of these protocols could be considered essential to the rehabilitation process.…”

Section: Objectivesmentioning

confidence: 99%

“…Overloading can detrimentally affect healing time, the stability of the healing structure (Hambly et al, 2006), or cause plastic, brittle or fatigue failure of implant or operative sites (Hustedt et al, 2012). Conversely, adequate weight bearing encourages the healing process, for example by osteoblastic stimulation at fracture and fixation sites (Meadows, Bronk, Chao & Kelly, 1990). The teaching and accuracy of reproduction of PWBPs in clinic settings is typically assessed statically using bathroom scales (Hambly et al, 2006), however, studies in both injured and uninjured subjects have led to the conclusion that PWBP reproducibility is poor (Hustedt et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Are current methods of partial weight-bearing instruction accurately translating to crutch-assisted gait?

Graham

Stephens

Dietz

et al. 2016

International Journal of Therapy and Rehabilitation

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Study Design: Repeated measures, Williams crossover design. Objectives:The aim of this study was to determine the accuracy with which weight-bearing protocols (20%, 50% or 80% of body weight (BW)) could be reproduced shortly after being taught.Background: Partial weight bearing protocols (PWBPs) are commonly incorporated into hospital, clinical and field based rehabilitation (Hershko, Tauber & Carmeli, 2008), to enhance recovery, particularly in patients following cartilage surgeries. Overloading can affect healing time and the stability or integrity of the healing structure (Pauser et al., 2012), however underloading can also be detrimental as adequate weight bearing encourages the healing process, for example osteoblastic stimulation (Meadows, Bronk, Chao & Kelly, 1990). Therefore accurate reproducibility of these protocols could be considered essential to the rehabilitation process.Methods: 30 participants were taught three partial weight bearing protocols (20%, 50% and 80% BW), using bathroom scales. Participants ability to reproduce their target load for each protocol was assessed statically using bathroom scales and dynamically with a force plate using a 3point elbow crutch assisted gait. Participants were assessed 10 minutes after being taught. Errors between actual and target load during these trials was calculated. Results:Accuracy assessed with scales was comparatively good for all target loads, however dynamic trials using the force plate showed an inverse relationship between all error measures and target loads (i.e. 20% > 50% > 80% BW; all p<0.01). The peak error was double the intended load at 20%BW (95% CI: 11.9%BW, 24.1%BW). At 80%BW the peak error was not significantly different from zero. Conclusion:The static method of instruction of PWBPs, using bathroom scales, does not seem to translate accurately to dynamic motion, and therefore affects adherence to medical instruction.Practitioners should be aware of the potential errors in reproducing these loads and the potential effect on rehabilitation. These results would suggest that practitioners should be cautious when using bathroom scales to teach PWBPs and not rely on them to assess reproduction accuracy during gait. Level of evidence:Controlled laboratory study, randomized cross-over design.

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Effect of weight-bearing on healing of cortical defects in the canine tibia.

Cited by 81 publications

References 0 publications

Nonunion of the femoral diaphysis

Nonunion of the femoral diaphysis

Healing of 56 segmental femoral shaft fractures after locked nailing: Poor results of dynamization

Are current methods of partial weight-bearing instruction accurately translating to crutch-assisted gait?

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