Predictors of Delayed Union Following Locking Compression Plate Fixation of Tibial Shaft Fractures: A Prospective Observational Study
Abstract
Introduction: Delayed union remains a significant challenge following locking compression plate (LCP) fixation of tibial shaft fractures, resulting in prolonged recovery and increased healthcare burden. The present study aimed to evaluate the clinical, biochemical, and radiological factors associated with delayed union following LCP fixation of tibial shaft fractures.
Materials and methods: This prospective observational study included 125 adult patients with tibial shaft fractures managed with LCP fixation at a tertiary care teaching hospital. Clinical, biochemical, and radiological parameters were prospectively recorded and compared between patients with normal union (n = 100) and delayed union (n = 25). Variables demonstrating a P < 0.10 on univariate analysis were entered into a multivariable binary logistic regression model to identify independent predictors of delayed union.
Results: Delayed union occurred in 25 (20.0%) patients. Compared with the normal union group, patients with delayed union demonstrated significantly longer times to radiological union (27.6 ± 5.3 vs. 22.1 ± 4.1 weeks; P < 0.001) and unrestricted weight-bearing (23.8 ± 4.7 vs. 18.9 ± 3.6 weeks; P < 0.001). Non-union (16.0% vs. 1.0%; P = 0.005) and reoperation (20.0% vs. 3.0%; P = 0.008) were also significantly more frequent among patients with delayed union. Although several variables, including body mass index, smoking status, serum albumin, vitamin D levels, fracture gap, and radiographic union…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 125 participants or records.
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