title: Measuring stiffness can define healing of tibial fractures.
abstract: We measured fracture stiffness in 212 patients with tibial fractures treated by external fixation. In the first 117 patients (group 1) the decision to remove the fixator and allow independent weight-bearing was made on clinical grounds. In the other 95 patients (group 2) the frames were removed when the fracture stiffness had reached 15 Nm/degree. In group 1 there were eight refractures and in group 2 there was none (p = 0.02, Fisher's exact test). The time to independent weight-bearing was longer in group 1 (median 24 weeks) than in group 2 (21.7 weeks, p = 0.02). The greater precision of our objective measurement was associated with a reduction in refracture rate and in the time taken to achieve independent weight-bearing. We consider that a stiffness of 15 Nm/degree in the sagittal plane provides a useful definition of union of tibial fractures.
authors.affiliation: Robert Jones and Agnes Hunt Orthopaedic, Oswestry, England.
authors.forename: J B
authors.initials: JB
authors.lastname: Richardson
authors.forename: J L
authors.initials: JL
authors.lastname: Cunningham
authors.forename: A E
authors.initials: AE
authors.lastname: Goodship
authors.forename: B T
authors.initials: BT
authors.lastname: O'Connor
authors.forename: J
authors.initials: J
authors.lastname: Kenwright
mesh_terms: D001696:Biomechanical Phenomena; D005592:Fracture Fixation; D006801:Humans; D013977:Tibia / Q000503:physiopathology; D013978:Tibial Fractures / Q000503:physiopathology*; D016474:Weight-Bearing / Q000502:physiology; D014945:Wound Healing / Q000502:physiology