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Complications of tibial osteotomies in children with comorbidities
K Rad Payman1, Victoria Patenall, Peter Borden
1Shriners Hospitals for Children, University of California, Los Angeles 90020-1199, California, USA. rpayman@hotmail.com
Insights
Tibial osteotomies in children can lead to complications, with comorbidities significantly increasing risk. External fixation showed fewer issues than pins and casting, emphasizing preoperative assessment.
Area of Science:
- Orthopedic Surgery
- Pediatric Orthopedics
- Surgical Complications
Background:
- Tibial osteotomies are common orthopedic procedures in children.
- These procedures carry potential risks and complications that require careful monitoring.
Purpose of the Study:
- To retrospectively review tibial osteotomies in children to identify and assess complication rates.
- To investigate factors influencing complication incidence, including comorbidities and fixation methods.
Main Methods:
- Retrospective review of 116 children undergoing 129 tibial osteotomies.
- Data collected on complication types, locations, comorbidities, and fixation methods (external fixation vs. pins and casting).
Main Results:
- Overall low complication rate observed.
- Wound problems (35), recurrence/reoperation (6), delayed union (5), peroneal nerve palsy (2), nonunion (1), and mal-union (1) were recorded.
- Comorbidities were significantly associated with higher complication frequency.
- External fixation demonstrated a lower complication incidence compared to pins and casting.
Conclusions:
- Comorbid conditions in pediatric patients undergoing tibial osteotomies are strongly linked to increased postoperative complications.
- Preoperative identification of comorbidities is crucial for risk assessment and management.
- External fixation may be associated with a lower complication rate than traditional methods.
Abstract:
Tibial osteotomies in children have been associated with a number of complications. A retrospective review of 116 children who had 129 tibial osteotomies was performed to assess these complications at our institution. Results showed that there were 35 cases of wound problems, 6 cases of recurrence/reoperation, 5 cases of delayed union, 2 cases with transient peroneal nerve palsy, 1 case of nonunion, and 1 case of mal-union. Patients having certain comorbidities had a higher frequency of complications. There were no significant differences between the location of the tibial osteotomy (proximal or distal) and the incidence of complication. External fixation was associated with a lower incidence of complications than the use of pins and casting. Although our results demonstrate an overall low complication rate, there is a significant association between complications and comorbid conditions. This highlights the need to recognize comorbidities preoperatively and the potential of increased postoperative complications.
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