The view of Brazilian orthopedists on partial weight bearing in open fractures of the tibial shaft following osteosynthesis

• Published in: Revista brasileira de fisioterapia (São Carlos (São Paulo, Brazil)) Brazil)), 2009-12, Vol.13 (6), p.514-520
• Main Authors: Sella, VRG, Machado, PCD, Fernandes, HJA, Limonge, W R, Reis, F B, Faloppa, F
• Format: Article
• Language: Portuguese
• ISSN: 1413-3555

Background: Tibial shaft fractures are the most frequent among long bone fractures. They are described in the literature according to the device and method of treatment, with recommendations that range from full weight bearing to non-weight bearing restrictions. There are studies comparing osteosynthesis devices and surgical aspects, but no references were found on how or when to allow weight bearing on the affected limb in the standing position. Objectives: The present study learned from Brazilian orthopedists which methods of osteosynthesis they use to treat open tibial fractures, whether they refer patients to physical therapy, when and why they allow partial weight bearing for both physical activity and therapy. Methods: Two hundred and thirty-five orthopedists answered a questionnaire during the 14 super(th) Brazilian Conference of Orthopedic Trauma. Results: The results showed that, in Brazil, the most widely used osteosynthesis device is the external fixator, but earlier weight bearing while standing occurs when intramedullary nails are used. Most orthopedists refer patients to physical therapy and allow partial weight bearing in the standing position according to the material used for synthesis. Conclusions: It was concluded that there is a preference for external fixation, that most orthopedists refer patients to physical therapy and that the synthesis material influences restrictions on partial weight bearing.Original Abstract: Contextualizacao: As fraturas da diafise da tibia sao as mais frequentes dentre as dos ossos longos. Ha descricoes na literatura, de acordo com o metodo e dispositivo de tratamento, com recomendacoes que vao desde a descarga total ate a proibicao do suporte de peso corporal em ortostase. Existem estudos comparando os dispositivos de osteossintese e os diversos aspectos cirurgicos, porem nao sao encontradas referencias que descrevam como e quando se deve liberar a descarga sobre o membra acometido na posicao ortostatica. Objetivos: Verificar, entre os ortopedistas brasileiros, qual ou quais sao os metodos de osteossintese adotados para o tratamento de fraturas expostas de tibia, se indicam o tratamento fisioterapico, quando e quais fatores influem para liberar a descarga parcial em ortostase, tanto para a funcao quanta para a fisioterapia. Metodos: 235 ortopedistas responderam a um questionario durante o XIV Congresso Brasileiro de Trauma Ortopedico. Resultados: Os resultados mostraram que, no Brasil, o dispositivo de osteo