[Objective]To investigate the effectiveness of axial load-sharing ratio test in assessing the rigidity of callus of tibial frac-tures for the removal of unilateral external fixator.[Methods]A retrospective study was conducted on 49 patients who were admitted to Tianjin Hospital for tibial fractures from January 2017 to July 2020.All patients received unilateral external fixator within 2 weeks after in-jury.According to random number table method,axial load sharing ratio was measured in 24 patients(the tested group),while not tested in other 25 patients(the routine group).The perioperative,follow-up and imaging data of the two groups were compared.[Results]All patients in both groups had the treatment completed successfully,without significant differences in operation time,total incision length,intraopera-tive blood loss,intraoperative fluoroscopy times,walking time,incision healing,hospital stay,and adjustment time of external fixator be-tween the two groups(P＞0.05).With time of follow-up period lasted for(10.5±2.4)months on an average,the VAS score,knee flexion-ex-tension rang of motion(ROM)and ankle plantar flexion-dorsal extension ROM significantly improved in both groups(P＜0.05),which were not statistically significant between the two groups at any time points accordingly(P＞0.05).However,the time interval bearing the external frame in the tested group was significantly less than that in the routine group[(198.8±36.4)days vs(315.7±51.8)days,P＜0.001],whereas there were no significant differences in adverse events,such as incidence of pin infection and refracture between the two groups(P＞0.05).As for imaging,the tibial alignment significantly improved in both groups after frame adjustment compared with that immediately after oper-ation(P＜0.05),while the quality of callus formation in both groups gradually improved over time(P＜0.05).However,the routine group had significantly better the quality of callus on images than the tested group at the time of frame removal[excellent/good/poor,(23/2/0)vs(13/11/0),P=0.002].[Conclusion]Regular application of axial load sharing ratio test can safely and timely guide the removal of unilateral external fixator for tibial fracture,and the effect is safe and reliable.
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