Casting versus surgical fixation for grade IIIA open tibial diaphysial fractures in children: effect on the rate of infection and the need for secondary surgical procedures to promote bone union
C P Charalambous, F Alvi, I Siddique, M Zenios, P Hirst, P Marshall, C P Charalambous, F Alvi, I Siddique, M Zenios, P Hirst, P Marshall
Abstract
We evaluated 39 grade IIIA open tibial fractures presenting in children younger than 13 years of age, to determine if the mode of fracture stabilization (casting vs. surgical fixation) was related to the rate of infection or the need for secondary surgical procedures to promote bone union. All fractures had wound debridement in the operating room. Thirty patients had manipulation and casting, and nine surgical internal or external fixation. There were two cases of infection in the cast-treated group and two in the surgical fixation group (P=0.17). None of the fractures required a secondary surgical procedure to promote bone union. Three of the fractures treated by manipulation and casting displaced; two required re-manipulation and casting and one was converted to external fixation. In two cases the applied external fixator had to be re-aligned. Our results suggest that manipulation and casting is a reliable treatment for open tibial fractures in children.
References
- {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1097/00005131-199707000-00010', 'is_inner': False, 'url': 'https://doi.org/10.1097/00005131-199707000-00010'}, {'type': 'PubMed', 'value': '9294800', 'is_inner': True, 'url': 'http://pubmed.ncbi.nlm.nih.gov/9294800/'}]}
- Bartlett CS, Weiner LS, Yang EC (1997) Treatment of type II and type III open tibia fractures in children. J Orthop Trauma 11(5):357–362
- {'text': '', 'ref_index': 1, 'ids': [{'type': 'PubMed', 'value': '8698721', 'is_inner': True, 'url': 'http://pubmed.ncbi.nlm.nih.gov/8698721/'}]}
- Cullen MC, Roy DR, Crawford AH, Assenmacher J, Levy MS, Wen D (1996) Open fracture of the tibia in children. J Bone Joint Surg Am 78(7):1039–1047
- {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1097/00003086-199611000-00009', 'is_inner': False, 'url': 'https://doi.org/10.1097/00003086-199611000-00009'}, {'type': 'PubMed', 'value': '8913146', 'is_inner': True, 'url': 'http://pubmed.ncbi.nlm.nih.gov/8913146/'}]}
- Grimard G, Naudie D, Laberge LC, Hamdy RC (1996) Open fractures of the tibia in children. Clin Orthop Relat Res 332:62–70
- {'text': '', 'ref_index': 1, 'ids': [{'type': 'PubMed', 'value': '2406275', 'is_inner': True, 'url': 'http://pubmed.ncbi.nlm.nih.gov/2406275/'}]}
- Gustilo RB, Merkow RL, Templeman D (1990) The management of open fractures. J Bone Joint Surg Am 72(2):299–304
- {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1016/S0020-1383(03)00031-7', 'is_inner': False, 'url': 'https://doi.org/10.1016/s0020-1383(03)00031-7'}, {'type': 'PubMed', 'value': '14519359', 'is_inner': True, 'url': 'http://pubmed.ncbi.nlm.nih.gov/14519359/'}]}
- Jones BG, Duncan RD (2003) Open tibial fractures in children under 13 years of age–10 years experience. Injury 34(10):776–780
- {'text': '', 'ref_index': 1, 'ids': [{'type': 'PubMed', 'value': '7560040', 'is_inner': True, 'url': 'http://pubmed.ncbi.nlm.nih.gov/7560040/'}]}
- Kreder HJ, Armstrong P (1995) A review of open tibia fractures in children. J Pediatr Orthop 15(4):482–488
- {'text': '', 'ref_index': 1, 'ids': [{'type': 'PubMed', 'value': '8865050', 'is_inner': True, 'url': 'http://pubmed.ncbi.nlm.nih.gov/8865050/'}]}
- Song KM, Sangeorzan B, Benirschke S, Browne R (1996) Open fractures of the tibia in children. J Pediatr Orthop 16(5):635–639
Source: PubMed