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June 25, 2025Frontiers in Bioengineering and BiotechnologyOpen Access

Gait analysis with smart insoles can identify patients at risk of tibial shaft fracture nonunion as early as six weeks after surgery: longitudinal and cross-sectional study

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Authors

EWElke WarmerdamMOMarcel OrthMMMax Müller

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Overview

Cohort study reveals smart insole gait metrics detect nonunion risk in tibial fracture patients at six weeks, indicating earlier intervention opportunities.

Key Points

  • To determine whether gait analysis using sensor-equipped insoles and PROMIS questionnaires can identify patients at risk of nonunion during recovery from tibial shaft fractures.
  • Evaluated gait metrics (pressure, temporal, angular velocity, and acceleration) using OpenGO instrumented insoles alongside PROMIS questionnaires in longitudinal (N=18) and cross-sectional (N=4) cohorts.
  • Assessed patients at 1 week, 6 weeks, 3 months, and 6 months post-surgery, with bone union status established via radiographs at 6 months.
  • Significant differences in gait patterns emerged between union and nonunion groups at 6 weeks post-surgery (16 of 33 parameters differed), identifying healing failure earlier than radiographs or PROMIS questionnaires.
  • At 3 months post-surgery, nonunion patients showed significant differences in center of pressure width (p=0.022), stride time (p=0.035), stride frequency (p=0.008), maximal angular velocity (p=0.014), and maximal angular velocity asymmetry (p=0.035).

Cite This Study

Warmerdam et al. (2025) studied this question.

synapsesocial.com/papers/6a83f266d65172829ee66befhttps://doi.org/10.3389/fbioe.2025.1536738
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Identification of biomechanical alterations associated with nonunion after tibial shaft fractures using musculoskeletal simulation based on motion capture and instrumented insole data2026
  2. 2Patient-Reported Outcome Measurement Information Systems Physical Function and Pain Interference Scores Are Correlated With Tibial Shaft Fracture Nonunion Following Intramedullary Nailing2024 · 3 citations
  3. 3Three predictive scores compared in a retrospective multicenter study of nonunion tibial shaft fracture2024 · 2 citations
  4. 4Can Tibial Nonunion be Predicted at 3 Months After Intramedullary Nailing?2013 · 31 citations
  5. 5A Fracture Healing Odyssey: Kinematic Comparison of Unions and Nonunions in Human Lower-Extremity Long Bones Treated with Intramedullary Nailing2026