Surgical management of burst fractures in children and adolescents: A Multicentre Retrospective Study

The objective of this study was to assess the clinical and radiographic outcomes of surgical management in a multicentre cohort of paediatric patients with burst fractures, in order to devise an optimal therapeutic strategy.HypothesisA therapeutic strategy for burst fractures in children and adolescents can be devised based on data from a patient cohort and on previously published information.Material and methodsPatients younger than 18 years who were managed surgically for one or more burst fractures (Magerl A3) were included in this retrospective multicentre study. Clinical, radiographic, and surgical data were collected before surgery, within 3 months after surgery, and 2 years after surgery. The primary surgical approach was posterior in all patients. Computed tomography (CT) was performed post-operatively to assess the extent of anterior bone loss in order to determine whether anterior fusion was required. The 26 included patients had a mean age of 15 ± 1 years. The thoraco-lumbar spine was involved in 15 (57%) patients. Surgery consisted in correction by instrumentation and posterior fusion only in 14 patients and in posterior correction with anterior fusion in 12 patients. In 10 (38%) patients, the instrumentation extended one vertebra above and one vertebra below the fractured vertebra.ResultsSignificant correction of the vertebral kyphosis was achieved (17° ± 11° before vs. 4° ± 2° after surgery, p = 0.001). Anterior and...
Source: Orthopaedics and Traumatology: Surgery and Research - Category: Orthopaedics Source Type: research