Open fractures of the tibia in children

Irwin, Andrew; Gibson, Patrick; Ashcroft, G. W.

doi:10.1016/0020-1383(95)90547-b

Cited by 42 publications

(19 citation statements)

References 6 publications

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“…One of the main finding in this study was the encouraging success rate registered with primary closure following a strict protocol guideline; there was 100% success with type I fractures and 60% success with type II. The success rate compares favorably with similar reports of primary closures 11,12 and matches the primary closure success rate recorded in elective orthopaedic surgical wounds 13 . In this study however, some forms of type II and III a , recorded only 60% and 22% success respectively with primary closure.…”

Section: Discussionsupporting

confidence: 86%

Early Management of Open Tibial Fractures in Benin - City - Result of a Structured Treatment Protocol

Philipa¹,

Mobashb²,

Osemogie³

2009

Journal of Medicine and Biomedical Research

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Section: Discussionsupporting

confidence: 86%

Early Management of Open Tibial Fractures in Benin - City - Result of a Structured Treatment Protocol

Philipa¹,

Mobashb²,

Osemogie³

2009

Journal of Medicine and Biomedical Research

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“…For studies that provided the ages of the pediatric patients (12 studies, n = 581), the weighted average age at time of injury was 9.3 years (range 2-18 years) [1][2][3][4][5][6][8][9][10][11][12][13]. Gender information was provided for 675 patients (13 studies), of whom 173 (26%) were female and 502 (74%) were male [1][2][3][4][5][6][7][8][9][10][11][12][13] (25; 12%). The presence of a fibula fracture was not routinely documented in the respective studies; for consistency, we therefore chose to eliminate this from the focus of the study.…”

Section: Methodsmentioning

confidence: 99%

Open fractures of the tibia in the pediatric population: A systematic review

Baldwin

Babatunde

Huffman

et al. 2009

Journal of Children's Orthopaedics

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PurposeThe management of open fractures of the tibia in a pediatric population represents a challenge to the clinician. Several case series over the course of many years have been performed describing the results of treating these injuries. It remains unclear, however, whether there is a preferred modality of treatment for these injuries, if a more severe injury confers a greater risk of infection, and if time to union is affected by Gustilo type, although trends seem to exist. The purpose of this study was to assemble the available data to determine (1) the risk of infection and time to union of various subtypes of open tibia fractures in children and (2) the changes in treatment pattern over the past three decades. Methods A systematic review of the available literature was performed. Frequency weighted mean union times were used to compare union times for different types of open fractures. Mantel Haentzel cumulative odds ratios were used to compare infection risk between different types of open fractures. Linear regression by year was used to determine treatment practices over time.Results No significant change in practice patterns was found for type I and III fractures, although type II fractures were more likely to be treated closed in the later years of the study compared to the earlier years. Type III fractures conferred a 3.5-and 2.3-fold greater odds of infection than type I and type II fractures, respectively. There was no significant difference in odds of infection between type I and II fractures. There was a significant delay in mean time to union between type I and type II fractures, and between type II and type III fractures. Conclusions With the exception of type II fractures, the philosophy of treatment of open fractures of the tibia has not significantly changed over the past three decades. Closed treatment or internal fixation are both viable options for type II fractures based on their relatively low incidence of infection. This study also demonstrates a strong relationship between Gustillo sub-types and odds of infection in this population. Not surprisingly, union rates are also delayed with increasing injury severity.

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“…5,6,23,24 The initial treatment consists of the administration of intravenous antibiotics and tetanus prophylaxis; this is followed by copious irrigation and thorough cleansing of the wound. 4,5,[23][24][25][26] After adequate debridement, first-degree open and clean fractures can have the wound loosely sutured, and a drainage tube can be fixed, but in most cases, the wounds should be left open, as among other reasons, they might be submitted to further debridement. 25 Kreder and Armstrong 24 noticed that a delay of more than six hours in surgical cleaning was correlated to 25% of infection in comparison with 12% for patients operated within a time limit of up to six hours.…”

Section: Open Fracturesmentioning

confidence: 99%

Fraturas da diáfise da tíbia em crianças

Santili¹,

Gomes²,

Akkari³

et al. 2010

Acta ortop. bras.

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Tibial diaphyseal fractures in children and adolescents are relatively common injuries and often evolve with good results when treated through traditional methods of conservative treatment. Their elevated frequency is due to the high degree of exposure of children in physical activities and also to the topographic location, exposing them to direct or indirect trauma. The approach used should consider and respect some features regarding age, place of affection (whether proximal or distal), type of fracture and therapy. The anatomical advantage of a thicker periosteum and flexibility when submitted to angular impacts can provide younger children with greater stability and, consequently, increases their chances of a better prognosis than older children and adolescents. In the latter, the degree of exposure to highenergy trauma and the greater complexity and severity of injuries have caused the recent trend towards stabilization surgery to become more common. Frequent complications in the evolution of fractures in adults such as infection, delayed union and nonunion are much less common in children, although the risk of occurrence of compartment syndrome is an event that requires attention, especially with plaster.

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Open fractures of the tibia in children

Cited by 42 publications

References 6 publications

Early Management of Open Tibial Fractures in Benin - City - Result of a Structured Treatment Protocol

Early Management of Open Tibial Fractures in Benin - City - Result of a Structured Treatment Protocol

Open fractures of the tibia in the pediatric population: A systematic review

Fraturas da diáfise da tíbia em crianças

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