The Influence of Early Weight-Bearing Training with Real-Time Supervision on Postoperative Rehabilitation of Tibial Shaft Fractures: Case Series Report

This study investigated the impact of the timing of early weight-bearing on the healing of tibial shaft fractures, a common type of long bone fracture influenced by blood supply and mechanical stimulation during the healing process. Early weight-bearing has been shown to promote fracture healing and preserve joint function. Despite previous studies confirming the safety of early weight-bearing, the effects of different initial weight-bearing times on rehabilitation outcomes are still uncertain. The study included six patients who underwent tibial intramedullary nailing surgery and were divided into three groups: Group A (starting partial weight-bearing exercises at two weeks post-surgery), Group B (starting at four weeks post-surgery), and Group C (starting at six weeks post-surgery). Real-time monitoring of insole pressure system was used to supervise patients' daily training and improve compliance. The study conducted a thorough assessment of postoperative rehabilitation outcomes by considering gait parameters, functional assessments, and the modified RUST score (mRUST). Results revealed that patients in groups A and B achieved bone healing (mRUST 13) by postoperative week 12, while patients in group C achieved bone healing at postoperative weeks 16 and 24, indicating a slower healing rate. Groups A and B also showed higher cadence and better load symmetry compared to group C at postoperative week 24. Additionally, patients in groups A and B exhibited better performance in the 10-meter walk test and Timed Up and Go test at postoperative week 24 than those in group C. The study concludes that supervised early weight-bearing can contribute to patient recovery.