Impact of early loading on fracture healing with intramedullary nailing.

Introduction: Tibial diaphyseal fractures are one of the most common types of fractures in practise of the orthopedics and traumatology. In this study, clinical results of the patients with diaphyseal fractures of the tibia which have been treated with locking intramedullary nailing tecnique and the weight bearing time and union time has been evaluated. Method: Patients who applied to our hospital with tibial diaphyseal fractures were evaluated retrospectively. 43 patients were included in the study. Karlstrom-Olerud, Johner and Wruhs score were used to evaluate clinical results. Radiologic improvement was assessed as loss of callus formation and / or fracture line at the level that the patient could load without support on radiographs. Clinical improvement was assessed as the patient was able to give full pain relief and return to daily activities. Results: Mean duration of union was 11.36 ± 3.8 (6-20) weeks. According to Karlstrom-Olerud 21 patients (47,7%) has received a full grade of 36, 14 patients (31,8%) have been evaluated as good with a grade between 33 and 35, 1 patient (2,3%) was satisfactory with a grade in the range 30-32 and 8 patients were in the range 27-29 and they are evaluated as fair. Non of the patients were evaluated as poor. Conclusion: Patients have an excellent and good score according to the Johner-Wrush criteria. According to Karlstrom-Olerud's physical functional assessment scale, no patient had a bad scar. Younger, early-weight-bearing patients with a nail cortex distance of less than 2mm, the duration of union is shortening