Paediatric tibial shaft fractures treated by open reduction and stabilization with monolateral external fixation
| Autor: | Christophe Vidal, N. Apostolou, Keyvan Mazda, E. Ferrero, Brice Ilharreborde, A L Simon |
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| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Radiography law.invention Intramedullary rod operative intervention 03 medical and health sciences External fixation 0302 clinical medicine children law external fixation 030225 pediatrics skeletal immaturity medicine Original Clinical Article Orthopedics and Sports Medicine Reduction (orthopedic surgery) 030222 orthopedics business.industry Mean age tibial fracture Lateral side Limb length 3. Good health Surgery Mechanism of injury Pediatrics Perinatology and Child Health business |
| Zdroj: | Journal of Children's Orthopaedics |
| ISSN: | 1863-2521 |
| Popis: | Purpose Elastic stable intramedullary nailing is increasingly used for surgical treatment of tibial shaft fractures, but frequently requires immobilization and delayed full weight-bearing. Therefore, external fixation remains interesting. The aim was to report clinico-radiological outcomes of monolateral external fixation for displaced and unstable tibial shaft fractures in children. Methods All tibial fractures consecutively treated by monolateral external fixation between 2008 and 2013 were followed. Inclusion criteria included skeletal immaturity and closed and open Gustilo I fractures caused by a direct impact. Patients were seen until two years postoperatively. Demographics, mechanism of injury, surgical data and complications were recorded. Anteroposterior and lateral side radiographs were performed at each visit. Full-limb 3D reconstructions using biplanar stereroradiography was performed for final limb length and alignment measures. Results A total of 45 patients (mean age 9.7 years ± 0.5) were included. In all, 17 were Gustilo I fractures, with no difference between open and closed fractures for any data. Mean time to full weight bearing was 18.2 days ± 0.7. After 15 days, 39 patients returned to school. Hardware removal (mean time to union 15.6 weeks ± 0.8) was performed during consultation under analgesic gas. There were no cases of nonunion. No fracture healed with > 10° of angulation (mean 5.1° ± 0.4°). Leg-length discrepancy > 10 mm was found for six patients. Conclusions This procedure can be a safe and simple surgical treatment for children with tibial shaft fractures. Few complications and early return to school were reported, with the limitations of non-comparative study. Level of Evidence IV |
| Databáze: | OpenAIRE |
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