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Complications of internal fixation in paediatric fractures
Audi B Widjaja1, Kevin Eng, John Griffiths
1Orthopaedic Unit, Monash Medical Centre, Clayton, Victoria, Australia. docaudi@hotmail.com
Insights
Internal fixation for pediatric fractures resulted in complications for 24.6% of children. Surgeons should carefully consider surgical intervention versus closed treatment for pediatric fractures.
Area of Science:
- Pediatric Orthopedics
- Surgical Complications
- Fracture Management
Background:
- Most pediatric fractures are managed non-surgically.
- Internal fixation is sometimes necessary for specific pediatric fractures.
- Assessing complication rates is crucial for treatment decisions.
Purpose of the Study:
- To determine the complication rate of internal fixation in pediatric fractures.
- To compare surgical intervention with non-surgical methods.
Main Methods:
- Retrospective analysis of 268 pediatric patients undergoing internal fixation.
- Fractures occurred between January 2000 and July 2004.
- Complications were classified as major or minor.
Main Results:
- A total of 24.6% of children experienced complications.
- Major complications occurred in 10% and minor in 18% of patients.
- 8.5% of children required additional surgery.
Conclusions:
- Internal fixation for pediatric fractures is associated with a significant complication rate.
- The risks of surgical intervention must be weighed against closed treatment.
- Prioritize closed treatment for pediatric fractures unless clear indications for surgery exist.
Background:
Most displaced fractures in children can be managed by closed treatment. Internal fixation of fractures is sometimes required to achieve satisfactory reduction with certain fractures. The aim of this study was to document the rate of complications associated with internal fixation of fractures in the paediatric age group.
Methods:
A retrospective study was carried out on 268 consecutive children who had internal fixation of fractures from January 2000 to July 2004. The complications were categorized as major or minor.
Results:
The average age was 9.2 years (range, 1.4-16.9). There were 327 fractures. Fifty-nine children had fractures of two bones. Humeral fractures accounted for 45.7% of fractures, forearm fractures 31.3%, tibial and fibular fractures 14.1% and femoral fractures 4.9%. There were 27 children (10%) with major complications and 49 children (18%) with minor complications. There were 18 children (6.7%) with both major and minor complications. A total of 66 (24.6%) children had complications. There were 23 children (8.5%) requiring further surgery.
Conclusions:
In this study, 24.6% of children had complications associated with internal fixation. The risk of complications should be considered when electing to proceed with surgical treatment. Closed treatment should always be attempted in children unless there is a good indication for internal fixation.
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