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Fifteen participants with isolated tibial diaphyseal fractures (OTA\/AO 42) at least 2 years postoperative from intramedullary nailing (IMN) provided informed consent. The average age was 40\u2009\u00b1\u200914 (range, 24\u201369); there were nine men and six women. Knee flexion\u2010extension strength data were collected. Temporal\u2010spatial, kinematic, and kinetic gait parameters were measured and compared to historic control data. Participants completed the SF\u201036 and shortened musculoskeletal function assessment questionnaires. The mean length of follow\u2010up between surgery and gait analysis was 6\u2009\u00b1\u20092 years. The fractured limb demonstrated deficits in quadriceps strength between 9.8% and 23.4% compared to the unaffected limb. Temporal\u2010spatial parameters revealed slower walking speed, shorter stride length, decreased cadence, and shorter single\u2010limb support time in the fractured limb. Altered kinematic and kinetic findings included a knee extension shift during stance, with an increased knee flexor moment demand and decreased total knee power during loading and midstance. These findings represent deficits in concentric and eccentric knee extensor activity. Additionally, the fractured limb demonstrated decreased ankle dorsiflexion during stance and diminished ankle push\u2010off power. Long\u2010term outcomes after IMN of tibial diaphyseal fractures demonstrate decreased quadriceps strength and altered gait parameters that may have implications to the high incidence of knee and ankle pain in the fractured limb.<\/jats:p>","DOI":"10.1002\/jor.25704","type":"journal-article","created":{"date-parts":[[2023,10,7]],"date-time":"2023-10-07T12:26:52Z","timestamp":1696681612000},"page":"618-627","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Gait and strength assessment following surgical repair by intramedullary nailing of isolated tibial shaft fracture"],"prefix":"10.1002","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7161-1760","authenticated-orcid":false,"given":"Karl","family":"Canseco","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery Medical College of Wisconsin Wauwatosa Wisconsin 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