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2025 ; 15
(1
): 37166
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gab.com Text
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Immediate full weightbearing with additive cerclage improves early mobility after
tibial shaft spiral fractures
#MMPMID41131343
Lisitano L
; Röttinger T
; Eger S
; Neuerburg C
; Mayr E
; Förch S
Sci Rep
2025[Oct]; 15
(1
): 37166
PMID41131343
show ga
In recent years, the trend in orthopedic and trauma surgery has shifted towards
earlier mobilization with reduced weightbearing restrictions to enhance patient
recovery. Tibial-shaft-spiral-fractures pose a challenge for early mobilization.
This study examines the use of additive cerclages, which allow for immediate
full-weightbearing, and compares it to the standard-of-care (SOC) treatment with
partial-weightbearing. The primary aim was to evaluate mobility,
return-to-daily-activities, and safety outcomes. This prospective multicenter
study included 36 patients with tibial-shaft-spiral-fractures. Group1 (n?=?20)
received an additive cerclage and was permitted immediate full
weightbearing-as-tolerated, while Group2 (n?=?16) followed SOC with 20 kg partial
weightbearing for 6 weeks. Gait analysis was performed at 1,3,6, and 12-weeks, as
well as 6-months post-surgery, using the loadsol(®) force-measuring device.
Patient-reported outcomes, including pain levels, quality of life (EQ-5D), and
return to daily activities, were assessed at these intervals. The results showed
that immediate weightbearing as tolerated led to significantly faster
mobilization. By week-3, 35% (7 of 20) of patients in Group1 were walking
unassisted compared to 6.25% (1 of 16) in Group 2 (p?=?0.04). By week 6, 75% (15
of 20) of patients in Group1 were walking without crutches, compared to 31.25% (5
of 16) in Group2 (p?=?0.002). Gait speed and mobility were significantly improved
in the cerclage group throughout the early postoperative period, with quality of
life scores also higher during the early postoperative phase (gait speed week 3
2.57?±?0.49 km/h vs. 2.16?±?0.70 km/h, p?=?0.032; EQ-5D week 1 3.59?±?0.85 vs.
3.05?±?0.56, p?=?0.017). No significant differences in complications were
observed between the groups. The use of additive cerclages for
tibial-shaft-spiral-fractures is a safe and effective method that allows for
immediate full-weightbearing, resulting in earlier mobilization and improved
short-term quality of life.Trail registration number: DRKS00035464 ( www.drks.de
), Date of registration: 17/12/2024.