Outcomes of displaced adolescent distal third tibia fractures: can we do better?

Because adolescent distal third tibia fractures pose treatment challenges, we aimed to identify factors predictive of failure among common treatment methods: casting without manipulation, closed reduction and casting (CRC) and open treatment. Among displaced fractures, we compared outcomes between CRC versus open treatment. Skeletally immature individuals (10–17 years) with extra-articular distal third tibia fractures at a level 1 trauma center (2011–2017) were retrospectively reviewed. Patient demographics, injury and treatment characteristics and complications were recorded. Radiographs were evaluated for unacceptable alignment (angulation>5°, translation>50%, and shortening>1 cm) and time to union. Of 140 individuals, casting was the most common treatment method (n = 81), followed by CRC under anesthesia/sedation (n = 38), and open treatment (n = 34). For fractures casted without manipulation, increased fracture severity based upon our novel grading system [hazard ratio (HR): 10.5, 95% CI, 4.2–27.5, P
Source: Journal of Pediatric Orthopaedics B - Category: Orthopaedics Tags: Trauma Lower Limb Source Type: research