Pediatric tibial shaft fractures

Nirav K Patel, Joanna Horstman, Victoria Kuester, Senthil Sambandam, Varatharaj MounasamyIndian Journal of Orthopaedics 2018 52(5):522-528Tibial shaft fractures are one of the most common pediatric fractures. They require appropriate diagnosis and treatment to minimize complications and optimize outcomes. Diagnosis is clinical and radiological, which can be difficult in a young child or with minimal clinical findings. In addition to acute fracture, Toddler's and stress fractures are important entities. Child abuse must always be considered in a nonambulatory child presenting with an inconsistent history or suspicious concomitant injuries. Treatment is predominantly nonoperative with closed reduction and casting, requiring close clinical and radiological followup until union. Although there is potential for remodeling, this may not be adequate with more significant deformities, thus requiring remanipulation or rarely, operative intervention. This includes flexible intramedullary nailing, Kirschner wire fixation, external fixation, locked intramedullary nailing, and plating. Complications are uncommon but include deformity, growth arrest, nonunion, and compartment syndrome.

Source: Indian Journal of Orthopaedics - September 4, 2018 Category: Orthopaedics Authors: Nirav K Patel Joanna Horstman Victoria Kuester Senthil Sambandam Varatharaj Mounasamy Source Type: research