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Long-term effects on tibial growth after intraosseous infusion: a prospective, radiographic analysis
I Claudet1, C Baunin, E Laporte-Turpin
1Department of Pediatric Emergency, Children Hospital, Toulouse, France. claudet.i@chu-toulouse.fr
Insights
Intraosseous infusion (IOI) in children does not affect tibial growth. Radiographic analysis confirmed no significant long-term differences in tibial length or width following proper IO trocar placement.
Area of Science:
- Pediatric Orthopedics
- Emergency Medicine
- Radiology
Background:
- Intraosseous infusion (IOI) is a critical emergency procedure in pediatric patients.
- Concerns exist regarding potential long-term effects of IOI on bone growth.
- Radiographic evaluation is essential for assessing skeletal development post-IOI.
Purpose of the Study:
- To evaluate the long-term radiographic effects of intraosseous infusion on tibial growth in a pediatric population.
- To determine if IOI impacts tibial length and width measurements.
- To assess the safety of IOI regarding skeletal development.
Main Methods:
- A prospective, simple blind study included pediatric patients requiring intraosseous trocars.
- Radiographs were taken during follow-up, measuring tibial length and width at diaphyseal levels.
- Measurements were compared to normative data and contralateral limbs where applicable.
Main Results:
- Twenty-three children completed the study with a mean follow-up of 29.2 months.
- Tibial length measurements remained within the 95% confidence interval compared to established tables.
- No statistically significant differences were observed between the punctured and control tibias in width or length.
Conclusions:
- Intraosseous infusion does not have a long-term adverse effect on tibial growth in pediatric patients.
- Proper placement of the intraosseous trocar is crucial for avoiding growth disturbances.
- Radiographic evidence supports the safety of IOI for pediatric bone development.
Background:
Evaluate, by radiographic analysis, tibial growth after an intraosseous infusion (IOI) in a pediatric population.
Methods:
We performed a prospective simple blind study, between January 1, 1994, and July 1, 2001, which included pediatric patients who needed an intraosseous trocar in emergency situations. During the follow-up, roentgenographs were performed. On each radiologic view, different measurements were carried out: anterior and lateral tibial length, anterior and lateral width at 2 diaphyseal levels. We compared the anterior length values to those published in the Anderson et al tables. When only one tibia was punctured, the mean measurements were compared with the control leg measurements using a paired t test.
Results:
The initial population included 78 patients. Of these 78 subjects, 42 died, 10 families could not be contacted, and one refused to participate. Two children were excluded because they had other conditions that could influence tibial growth. The study included 23 children. The puncture site was the proximal tibia. The mean age was 18.6 months at the time of IOI, the mean time of infusion was 5 hours, and the mean perfused volume was 225 mL. The mean radiologic follow-up time was 29.2 months. When compared with the Anderson et al tables, all the anterior length values were within the 95% confidence interval. For the other measurements, the statistical analysis showed no significant difference between punctured and control legs.
Conclusion:
There is no long-term effect on tibial growth after an IOI when the IO trocar is properly placed.
