# The Role of Serum Albumin Dynamics in the Healing of Simple Diaphyseal Tibial Fractures: A Prospective Observational Cohort Study

## TL;DR

This study shows that changes in blood albumin levels can predict whether tibial fractures heal properly or not.

## Contribution

It identifies serum albumin dynamics as a novel predictor for healing outcomes in tibial fractures.

## Key findings

- 16.36% of patients had impaired union of tibial fractures.
- Patients with healthy healing showed rising albumin levels, while those with impaired healing had declining levels.

## Abstract

Introduction

Diaphyseal tibial fractures are frequently encountered in clinical practice owing to the bone’s relatively subcutaneous position. These fractures occur along the tibial shaft between the knee and ankle joints and typically result from direct or indirect forces. This study was planned to determine the role of serum albumin in the healing of these fractures, thereby improving the overall management of patients with diaphyseal tibial fractures.

Materials and methods

This observational cohort study was conducted in the Department of Orthopedics, Provincial Headquarter Teaching Hospital Gilgit, from March 2022 to September 2025. A total of 110 patients with simple diaphyseal tibial fractures were included in the study. A detailed clinical history was obtained, a physical examination was performed, and a blood sample was subsequently drawn for the analysis of serum albumin levels. Patients were assessed for fracture union. Changes in serum albumin were compared between patients with normal union and those with impaired union of tibial diaphyseal fractures. All collected information was entered into the proforma.

Results

The mean age of the patients was 35.29 ± 11.77 years. The frequency of impaired union among patients treated for simple diaphyseal tibial fractures was 16.36% (18/110). A significant difference was observed in the mean change in serum albumin levels between the two groups. Patients in the Union Group demonstrated a positive mean change (0.24 ± 0.21 g/dL), whereas those in the Impaired Union Group exhibited a negative mean change (-0.40 ± 0.15 g/dL).

Conclusions

A changing pattern of serum albumin in the post-injury period is a strong predictor of healing outcomes in simple tibial fractures. A declining albumin level signals impaired union, whereas a rising level indicates healthy union.