Thesis (Ph.D.) - Cairo University - Faculty of Physical Therapy - Department of Musculoskeletal Disorders

Tibia is the most exposed bone in the body and vulnerable to trauma, so its fractures are common among the long bone fractures and its management needs various approaches to allow bone healing. The current study seeks to compare between low level laser therapy (LLLT) and controlled mechanical loading on healing of tibial shaft fractures immobilized with an external fixator. 26 patients with tibial shaft fracture immobilized with an external fixator participated in current study. They were assigned randomly into two groups with 13 patients in each. Group (A) was the laser group and group (B) was the controlled mechanical loading group. In group (A) laser applied 1st day after immobilized with an external fixator. A continuous wave 904 nm infrared laser was used at dose 4 j/cm2 each point at fracture site for 9 sessions (6 session in1st week and 3 sessions (every other day) in 2nd week), each session was 5 minutes. In group (B) static controlled mechanical loading with 25%of patient weight was applied for 36 successive cycles for 9 sessions (6 sessions in1st week and 3 sessions (every other day) in 2nd week). Then data collected by dual energy x-ray (DEXA) which measure bone mineral content (BMC) and bone mineral density (BMD), numerical rating scale (NRS) which measure pain and lower extremity functional scale (LEFS) which measure function of lower limb. The results of this study showed no significant difference in (BMC) and (BMD) between two groups but there are significant difference of numerical rating scale( NRS) & lower extremity functional scale (LEFS) in favor of group(A) when compared with group (B). Based on the results obtained in this study concluded that LLLT and mechanical controlled weight bearing had the same effect on bone healing, but LLLT has a greater effect on pain and LEFS

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