• Broken Collar Bone (Clavicle Fracture)
    • Shoulder Separation (AC Separation)
    • Shoulder Dislocation
    • Torn Labrum (Shoulder Instability)
    • Broken Shoulder (Proximal Humerus Fracture)
    • Broken Arm (Humerus Shaft Fracture)
    • AC Joint Arthritis
    • Rotator Cuff Tear
    • Torn Biceps
    • Biceps Tendonitis
    • Frozen Shoulder (Adhesive Capsulitis)
    • SLAP Tear (Superior Labrum Anterior to Posterior Tear)
    • Rotator Cuff Arthropathy
    • Shoulder Arthritis
    • Broken Elbow - Olecranon Fracture
    • Broken Forearm - Ulna Fracture
    • Broken Forearm - Radius Fracture
    • Radial Head Fracture
    • Elbow Dislocation
    • Elbow Bursitis (Swollen Elbow)
    • Tennis Elbow (lateral epicondylitis)
    • Golfer's Elbow (Medial Epicondylitis)
    • Elbow Stiffness
    • Elbow Arthritis
    • Broken Finger (phalanx fracture)
    • Nailbed Injury & Broken Finger Tip
    • Broken Thumb (First Metacarpal Fracture)
    • Broken Wrist (Distal Radius Fracture)
    • Scaphoid Fracture
    • Scapho-Lunate Dissociation
    • Broken Hand (Metacarpal Fracture)
    • Carpal Tunnel Syndrome
    • Nailbed and Finger Infections
    • Trigger Finger
    • DeQuervain's Tenosynovitis
    • Ganglion Cyst
    • Thumb Arthritis
    • Thumb Ligament Tear (Skiier's Thumb)
    • Wrist Arthritis
    • TFCC Tear
    • Hand Extensor Tendon Laceration
    • Hand Flexor Tendon Laceration
    • Jersey Finger
    • Mallet Finger
    • Finger Deformity: Swan Neck & Boutinerre
    • Hand Nerve Damage (Injury to Ulnar, Median, or Radial Nerve)
    • Hand - Dupytrens Disease
    • Broken Ankle (Distal Fibula Fracture)
    • Broken Heel Bone - Calcaneus Fracture
    • Broken Foot - Lisfranc Fracture
    • Broken Foot - Jones Fracture (5th Metatarsal Fracture)
    • Broken Foot - Talus Fracture
    • Broken Toe (phalanx fracture)
    • Turf Toe (Plantar Plate Injury)
    • Ankle Sprain
    • High Ankle Sprain (Syndesmotic Ligament Injury)
    • Hammertoe, Claw-toe, Mallet-toe deformity
    • Achilles Tendonitis
    • Achilles Tendon Tear
    • Plantar Fasciitis
    • Diabetic Foot
    • Charcot Foot
    • Bunion - Hallux Valgus & Hallux Rigidus
    • Acquired Flatfoot
    • OCD Lesion (Osteochondral Defect)
    • Back Pain
    • Back - Lumbar Stenosis
    • Back - Lumbar Disk Pain
    • Back - Lumbar Spondylolisthesis
    • Neck - Pinched Nerve (Cervical Radiculopathy)
    • Neck - Arthritis (Cervical Myelopathy)
    • Spine Injury - Compression Fracture
    • Spine Injury - Chance Fracture
    • Spine Injury - Den's Fracture (odontoid fracture)
    • Spine Injury - Central Cord Syndrome
    • Spine Injury - Facet Fracture & Dislocation
    • Spine - Lumbar Disk Herniation (Pinched Nerve)
    • Spine - Burst Fracture
    • Broken Hip (femoral neck fracture)
    • Femur Fracture
    • Snapping Hip
    • Hip Bursitis (trochanteric bursitis)
    • Hip Arthritis
    • Hip Replacement
    • Sports Hernia
    • Hip Pointer
    • FAI (Femoroacetabular Impingement)
    • Hamstring Tear
    • Broken Kneecap (Patella)
    • Kneecap Dislocation
    • Broken Knee (Tibial Plateau Fracture)
    • Broken Leg (Tibial Shaft Fracture)
    • Shin Bone Stress Fracture
    • Shin Splints
    • Quad Tear
    • Collateral Ligament Tear
    • ACL Tear
    • Meniscus Tear
    • Runners Knee
    • Knee - Arthritis
    • Knee Replacement
    • Kids - Broken Arm (Humerus Fracture)
    • Kids - Broken Elbow (Supracondylar Fracture)
    • Kids - Broken Elbow (Medial Epicondyle Fracture)
    • Kids - Broken Elbow (Lateral Condyle Fracture)
    • Kids - Radial Neck Fracture
    • Kids - Broken Forearm (Both Bone Forearm Fracture)
    • KIDS - Broken Leg (Pediatric Femur Fracture)
    • Kids - Broken Ankle (Distal Tibia Fracture)
    • Kids - SCFE (Slipped Capital Femoral Epiphysis)
    • Kids - Toddler Fracture
    • Kids - Growth Plate Injury
    • Scoliosis
    • DDH (Developmental Dysplasia of the Hip)
    • Coxa Vera
    • Perthes
    • Kids - Hip Infection (Septic Arthritis)
    • Kids - Bone Infection (Osteomyelitis)
    • Wry-Neck (Torticolis)
    • Metatarsus Adductus
    • Kids - Clubfoot
    • Pigeon Toed (Internal Rotation of the Leg)
    • Kids - Spondylolisthesis ("Spondi")
    • Pes Cavovarus (overarched foot)
    • Kids - Flatfoot (Pes Planus)
    • Bone Cyst
  • Blog
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Bone Talks

BROKEN BONES. TORN LIGAMENTS. MUSCLE STRAINS. EXPLAINED WITH PICTURES.
  • Shoulder&Arm
    • Broken Collar Bone (Clavicle Fracture)
    • Shoulder Separation (AC Separation)
    • Shoulder Dislocation
    • Torn Labrum (Shoulder Instability)
    • Broken Shoulder (Proximal Humerus Fracture)
    • Broken Arm (Humerus Shaft Fracture)
    • AC Joint Arthritis
    • Rotator Cuff Tear
    • Torn Biceps
    • Biceps Tendonitis
    • Frozen Shoulder (Adhesive Capsulitis)
    • SLAP Tear (Superior Labrum Anterior to Posterior Tear)
    • Rotator Cuff Arthropathy
    • Shoulder Arthritis
  • Elbow&Forearm
    • Broken Elbow - Olecranon Fracture
    • Broken Forearm - Ulna Fracture
    • Broken Forearm - Radius Fracture
    • Radial Head Fracture
    • Elbow Dislocation
    • Elbow Bursitis (Swollen Elbow)
    • Tennis Elbow (lateral epicondylitis)
    • Golfer's Elbow (Medial Epicondylitis)
    • Elbow Stiffness
    • Elbow Arthritis
  • Hand&Wrist
    • Broken Finger (phalanx fracture)
    • Nailbed Injury & Broken Finger Tip
    • Broken Thumb (First Metacarpal Fracture)
    • Broken Wrist (Distal Radius Fracture)
    • Scaphoid Fracture
    • Scapho-Lunate Dissociation
    • Broken Hand (Metacarpal Fracture)
    • Carpal Tunnel Syndrome
    • Nailbed and Finger Infections
    • Trigger Finger
    • DeQuervain's Tenosynovitis
    • Ganglion Cyst
    • Thumb Arthritis
    • Thumb Ligament Tear (Skiier's Thumb)
    • Wrist Arthritis
    • TFCC Tear
    • Hand Extensor Tendon Laceration
    • Hand Flexor Tendon Laceration
    • Jersey Finger
    • Mallet Finger
    • Finger Deformity: Swan Neck & Boutinerre
    • Hand Nerve Damage (Injury to Ulnar, Median, or Radial Nerve)
    • Hand - Dupytrens Disease
  • Foot&Ankle
    • Broken Ankle (Distal Fibula Fracture)
    • Broken Heel Bone - Calcaneus Fracture
    • Broken Foot - Lisfranc Fracture
    • Broken Foot - Jones Fracture (5th Metatarsal Fracture)
    • Broken Foot - Talus Fracture
    • Broken Toe (phalanx fracture)
    • Turf Toe (Plantar Plate Injury)
    • Ankle Sprain
    • High Ankle Sprain (Syndesmotic Ligament Injury)
    • Hammertoe, Claw-toe, Mallet-toe deformity
    • Achilles Tendonitis
    • Achilles Tendon Tear
    • Plantar Fasciitis
    • Diabetic Foot
    • Charcot Foot
    • Bunion - Hallux Valgus & Hallux Rigidus
    • Acquired Flatfoot
    • OCD Lesion (Osteochondral Defect)
  • Neck&Back
    • Back Pain
    • Back - Lumbar Stenosis
    • Back - Lumbar Disk Pain
    • Back - Lumbar Spondylolisthesis
    • Neck - Pinched Nerve (Cervical Radiculopathy)
    • Neck - Arthritis (Cervical Myelopathy)
    • Spine Injury - Compression Fracture
    • Spine Injury - Chance Fracture
    • Spine Injury - Den's Fracture (odontoid fracture)
    • Spine Injury - Central Cord Syndrome
    • Spine Injury - Facet Fracture & Dislocation
    • Spine - Lumbar Disk Herniation (Pinched Nerve)
    • Spine - Burst Fracture
  • Hip&Thigh
    • Broken Hip (femoral neck fracture)
    • Femur Fracture
    • Snapping Hip
    • Hip Bursitis (trochanteric bursitis)
    • Hip Arthritis
    • Hip Replacement
    • Sports Hernia
    • Hip Pointer
    • FAI (Femoroacetabular Impingement)
    • Hamstring Tear
  • Knee&Leg
    • Broken Kneecap (Patella)
    • Kneecap Dislocation
    • Broken Knee (Tibial Plateau Fracture)
    • Broken Leg (Tibial Shaft Fracture)
    • Shin Bone Stress Fracture
    • Shin Splints
    • Quad Tear
    • Collateral Ligament Tear
    • ACL Tear
    • Meniscus Tear
    • Runners Knee
    • Knee - Arthritis
    • Knee Replacement
  • Kids
    • Kids - Broken Arm (Humerus Fracture)
    • Kids - Broken Elbow (Supracondylar Fracture)
    • Kids - Broken Elbow (Medial Epicondyle Fracture)
    • Kids - Broken Elbow (Lateral Condyle Fracture)
    • Kids - Radial Neck Fracture
    • Kids - Broken Forearm (Both Bone Forearm Fracture)
    • KIDS - Broken Leg (Pediatric Femur Fracture)
    • Kids - Broken Ankle (Distal Tibia Fracture)
    • Kids - SCFE (Slipped Capital Femoral Epiphysis)
    • Kids - Toddler Fracture
    • Kids - Growth Plate Injury
    • Scoliosis
    • DDH (Developmental Dysplasia of the Hip)
    • Coxa Vera
    • Perthes
    • Kids - Hip Infection (Septic Arthritis)
    • Kids - Bone Infection (Osteomyelitis)
    • Wry-Neck (Torticolis)
    • Metatarsus Adductus
    • Kids - Clubfoot
    • Pigeon Toed (Internal Rotation of the Leg)
    • Kids - Spondylolisthesis ("Spondi")
    • Pes Cavovarus (overarched foot)
    • Kids - Flatfoot (Pes Planus)
    • Bone Cyst
  • Blog
Frontline of Orthopedics

our website is for educational purposes only.  the information provided is not a substitution for seeing a medical doctor.  for the treatment of a medical condition, see your doctor.  we update the site frequently but medicine also changes frequently.  thus the information on this site may not be current or accurate. 

 

Broken Leg: If my tibial shaft fracture gets surgery, when can I start walking on it?

June 26, 2016

When surgery is required for a broken bone, its important for patients to realize that the bone still needs time to heal after surgery .  The purpose of surgery for treating a broken bone is to re-align the bone so that it heals in the correct position...however, the bone still needs 6 weeks or longer (depending on the location of the break) to fully heal.  Basically surgery does not cause the bone to immediately fuse back together, it just holds the bone together so that over time, it fuses in the correct position.  

If a broken bone does not require surgery, it usually means that the break didn't cause the bone to move out of position, and therefore the bone just needs time to heal.  However, most orthopedic surgeons dont allow people to walk on a broken leg bone immediately because they dont want something to happen that causes the bone to move out of normal alignment.  Therefore, if a tibia (leg bone) is broken and not going to get surgery, its usually placed in a long leg cast for a few weeks.

One advantage of surgery, is that people dont have to wait up to 22 weeks for the broken leg to heal before they can start walking again.  If an "intramedullary nail" is used to fix the broken tibia (this is the most common type of surgery for a broken leg), people can typically walk on the leg immediately after surgery without a risk of the bone moving out of position or failing to heal properly.  

You would think that walking on a broken bone would prevent it from healing...but in reality, the pressure on the bone stimulates growth factors and the bone cells (osteoblasts) to start healing.  There have been a number of studies to suggest immediate weight bearing after fixing a broken tibia with an intramedullary nail (tibial IMN) is safe and effective.  

Its also been shown in other bones, like the femur, that immediate weight bearing is ok.  

 

References.

1. Coles CP, Gross M. Closed tibial shaft fractures: management and treatment complications. A review of the prospective literature. Can J Surg. 2000;43:256–262. full article. 

2. Can Tibial Shaft Fractures Bear Weight After Intramedullary Nailing A RandomizedControlled Trial. Gross SC et al. J Orthop Trauma. 2016 Jul;30(7):370-5. see paper.  no difference in full weight bear and nonweight bearing on overall healing (still takes about 22 weeks to achieve union).

3. Sarmiento A, Latta LL. Fractures of the middle third of the tibia treated with a functional brace. Clin Orthop Relat Res. 2008;466:3108–3115. see paper. 

4. Brumback RJ, Toal TR Jr, Murphy-Zane MS, et al. Immediate weight-bearing after treatment of a comminuted fracture of the femoral shaft with a statically locked intramedullary nail. J Bone Joint Surg Am. 1999;81:1538–1544. full article. 

5. Arazi M, Ogun TC, Oktar MN, et al. Early weight-bearing after statically locked reamed intramedullary nailing of comminuted femoral fractures: is it a safe procedure? J Trauma. 2001;50:711–716. see full article. 

6. McKibbin B. The biology of fracture healing in long bones. J Bone Joint Surg Br. 1978;60-B:150–162.  weight bearing is good for stimulating bone healing. full article. 

7.  Bone LB, Johnson KD. Treatment of tibial fractures by reaming and intramedullary nailing. J Bone Joint Surg Am. 1986;68:877–887

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