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Open fractures of the tibia in children
A Irwin1, P Gibson, P Ashcroft
1Royal Aberdeen Children's Hospital, Scotland, UK.
Injury
|January 1, 1995
Summary
This study reviews open tibial fracture treatments in 58 children. Most fractures healed well with various closure and immobilization techniques, with few complications like infection or delayed union.
Area of Science:
- Orthopedic surgery
- Pediatric trauma care
Background:
- Open tibial fractures in children present unique management challenges.
- Optimal treatment strategies aim to minimize complications and ensure functional recovery.
Purpose of the Study:
- To review the outcomes of treating open tibial fractures in pediatric patients.
- To evaluate the effectiveness of different wound management and fixation methods.
Main Methods:
- Retrospective review of 58 children (aged 3-15) with open tibial fractures.
- Analysis of fracture types (Gustilo I, II, III), wound management (primary closure vs. open), and immobilization techniques (plaster, external fixation).
Main Results:
- 83% immobilized in above-knee plaster, 10% with external fixation.
- Primary wound closure in 37, secondary healing or coverage in 21.
- All fractures healed without bone grafting; 3 delayed unions, 7 malunions.
- 6 superficial infections, 1 compartment syndrome; no deep infections or osteomyelitis.
- 2 amputations for Gustilo Type IIIc injuries.
Conclusions:
- Open tibial fractures in children can be managed successfully with appropriate wound care and fixation.
- While most cases achieve good bone healing, vigilance for complications like malunion and infection is crucial.
- Amputation is rare but necessary in severe, unsalvageable injuries.