OUTCOME OF EARLY VERSUS DELAYED WEIGHT BEARING FOLLOWING INTRAMEDULLARY INTERLOCKING NAILING OF TIBIAL SHAFT FRACTURES: A COMPARATIVE STUDY

Abstract

Background: Optimal timing of postoperative weight bearing after intramedullary interlocking nailing of tibial shaft fractures remains controversial, with concerns regarding fracture healing, implant stability, and functional recovery.

Objective: To compare outcomes of early versus delayed weight bearing following intramedullary interlocking nailing of tibial shaft fractures.

Methods: This comparative cross-sectional analytical study was conducted at Orthopaedics department of Gurki  Trusy and Teaching Hospital, Lahore from November 2024 to April 2025, including 210 patients with tibial shaft fractures treated with intramedullary interlocking nailing. 

Results: Baseline characteristics were comparable between groups. Early weight bearing resulted in significantly faster radiological union (15.8 ± 3.9 vs. 18.6 ± 4.8 weeks; p<0.001), earlier independent ambulation (9.4 ± 3.1 vs. 22.8 ± 6.7 days; p<0.001), shorter hospital stay (5.8 ± 1.9 vs. 8.6 ± 2.7 days; p<0.001), and quicker return to routine activity (10.7 ± 3.4 vs. 15.9 ± 4.2 weeks; p<0.001). Better knee and ankle range of motion and lower pain scores were also observed in the early group. Overall complication rates were lower with early weight-bearing (17.1% vs. 32.4%; p=0.01). Delayed weight bearing was an independent predictor of poor outcome (aOR 2.94; p=0.004).

Conclusion: Early weight bearing after intramedullary interlocking nailing of tibial shaft fractures appears safe and provides superior functional and radiological outcomes compared with delayed mobilization.