Displaced Distal Tibia Physeal Fractures: Short Leg Versus Long Leg Casting-A Prospective Study

Area of Science:

• Orthopedic surgery
• Pediatric trauma
• Fracture management

Background:

• Optimal treatment for pediatric distal tibia physeal fractures is debated.
• Long leg casts (LLC) traditionally provide rotational control.
• Short leg casts (SLC) may offer comparable efficacy.

Purpose of the Study:

• To compare the outcomes of SLC versus LLC in pediatric patients with displaced distal tibia physeal fractures.
• To evaluate reduction loss, pain, satisfaction, and premature physeal closure (PPC).

Main Methods:

• Prospective cohort study of pediatric patients with displaced distal tibia physeal fractures.
• Patients treated with either SLC or LLC based on surgeon preference.
• Follow-up included clinical evaluation, radiographs, and patient-reported outcomes.

Main Results:

• No significant difference in reduction loss between SLC and LLC groups.
• LLC group reported higher pain at cast removal, but satisfaction was similar.
• Premature physeal closure (PPC) occurred in 38% of patients, with no difference between cast types.

Conclusions:

• Short leg casts (SLC) are a viable option for treating displaced distal tibia physeal fractures in children.
• No increased risk of reduction loss or premature physeal closure (PPC) with SLC compared to LLC.
• Significant risk of PPC necessitates close monitoring regardless of cast type.