Open fractures of the tibia in children
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Updated: Aug 29, 2026
Pseudofracture: An Acute Peripheral Tissue Trauma Model
Published on: April 18, 2011
K M Song1, B Sangeorzan, S Benirschke
1Harborview Medical Center, Seattle, Washington, USA.
Insights
Open tibia fractures in children over 11 have outcomes similar to adults, while younger children experience a milder course. Aggressive wound care and stabilization are key for favorable outcomes in pediatric tibial shaft fractures.
Area of Science:
- Orthopedic Surgery
- Pediatric Traumatology
- Bone Healing
Background:
- Open tibia fractures in pediatric patients require careful management due to growth plate involvement.
- Understanding age-related differences in healing and complication rates is crucial for optimizing treatment.
Purpose of the Study:
- To evaluate outcomes of open tibia fractures in children with open growth plates.
- To analyze the impact of age, injury grade, and immobilization on fracture healing and complications.
Main Methods:
- Retrospective analysis of 38 pediatric patients (4-15 years) with open tibia fractures.
- Standardized treatment including operative debridement, antibiotics, and immobilization.
- Outcome assessment based on age, injury severity, and immobilization technique.
Main Results:
- Average time to union was 21 weeks; younger children (<11 years) did not require bone grafting.
- Deep infection and nonunion rates were 8%, exclusively in patients older than 11 years.
- Significant leg-length discrepancy or functional limitation occurred only with concurrent femur fractures or deep infection.
Conclusions:
- Pediatric open tibia fractures in patients over 11 years old exhibit complication rates comparable to adults.
- Younger children (<11 years) demonstrate a more favorable prognosis for open tibia fractures.
- Effective wound management and stabilization are critical for minimizing complications in pediatric tibial shaft fractures.
Abstract:
We treated 38 patients from 4 to 15 years old and with open growth plates for open fractures of the tibia. The average follow-up was 33 months (range, 9-122). All patients had repeated operative debridement, parenteral antibiotics, and immobilization by cast or fixation. Outcomes were analyzed with respect to age at the time of injury, grade of injury, and type of immobilization. The time to union was prolonged and averaged 21 weeks (range, 6-82). No patients younger than 11 years required bone grafting for union. The deep infection and nonunion rate was 8%, with all of these occurring in patients older than 11 years. Clinically significant leg-length discrepancy or functional limitation was encountered only in patients with an ipsilateral femur fracture or with deep infection requiring osseous debridement. Our data suggest that open tibia fractures in children older than 11 years have nonunion and infection rates that parallel those of adult patients, but that younger children have a more benign course. With aggressive wound care and adequate stabilization, few complications or sequelae should occur in open tibial shaft fractures in younger patients.
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