The Management of Soft Tissue and Bone Loss in Type IIIB and IIIC Pediatric Open Tibia Fractures

Laine, Jennifer C.; Cherkashin, Alexander; Samchukov, Mikhail; Birch, John G.; Rathjen, Karl E.

doi:10.1097/bpo.0000000000000492

Cited by 30 publications

(12 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…ESIN has been reported in the treatment for open tibial fractures in children, but there were also complications including infection, delayed union and angulation [10,11,23]. Besides, in Gustilo-Anderson Type III B and C injuries, only external xator is applied in our hospital, consistent with a previous study [24]. In patient with limited contamination such as GA grade I and II, minimal invasive technique of locking plate has also been reported [25,26].…”

Section: Discussionsupporting

confidence: 80%

Operative Choice for Open Tibial Shaft Fracture in Children: A Comparative Study of External Fixator Vs. Elastic Stable Intramedullary Nail

Hong

Rai

Tang

et al. 2021

Preprint

View full text Add to dashboard Cite

IntroductionExternal fixator (EF) is a preferred choice for open tibial fractures, but pin tract infection (PTI) and refracture are common complications. Elastic stable intramedullary nail (ESIN) has been reported in the treatment for open tibial fractures. This study aims to compare the clinical outcomes of EF vs. ESIN in the treatment for open tibial shaft fracture in children retrospectively.Material and methodsPatients aged 5-11 years old with Gustilo-Anderson II and IIIA tibial shaft fracture treated at our institute from January 2008 to January 2018 were reviewed retrospectively and categorized into EF (n = 55) and ESIN (n = 37) group. Patients with pathological fracture, neuromuscular disorder, metabolic disease, previous tibial fracture or instrumentation, and polytrauma were excluded. Patients with follow up less than 24 months or incomplete medical records were also excluded. ResultsIn all, fifty-five patients (33 males, 22 females) were included in the EF group, whereas 37 patients (21 males, 16 females) were included in the ESIN group. There was no significant difference between the two groups concerning sex, age, body weight, duration from injury to surgery, Gustilo-Anderson (GA) classification, and concomitant injuries. There was no patient of nonunion and malunion in either group. The incidence of implant prominence was higher in the ESIN group (16%) than those in the EF group (0), P < 0.001. The angulation was higher in the EF group than ESIN group in coronal and sagittal plane, P < 0.001. The radiological union was faster in the ESIN group (7.0 ± 0.9, weeks) than those in the EF group (9.0 ± 2.2), P < 0.001. Limb length discrepancy (LLD) was significantly longer in the EF group (12.1 ± 4.4, mm) than those in the ESIN group (7.3 ± 4.3, mm), P < 0.001. ConclusionESIN is a viable option in selected patients of GA grade II and IIIA open tibial fractures with comparable clinical outcomes as external fixator, but with less complications including superficial infection, residual angulation and refracture after hardware removal.

show abstract

Section: Discussionsupporting

confidence: 80%

Operative Choice for Open Tibial Shaft Fracture in Children: A Comparative Study of External Fixator Vs. Elastic Stable Intramedullary Nail

Hong

Rai

Tang

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…Of all the studies, there was no report of ESIN for the patient with Gustilo-Anderson Type III B and C injuries. Therefore, only external fixator is applied in our hospital for patients with severe open injuries, consistent with a previous study [ 23 ].…”

Section: Discussionsupporting

confidence: 66%

External fixation versus elastic stable intramedullary nailing in the treatment of open tibial shaft fractures in children

et al. 2021

View full text Add to dashboard Cite

Introduction External fixator (EF) is a popular choice for open tibial fractures, but pin tract infection (PTI) and refracture are common complications. Elastic stable intramedullary nail (ESIN) has been reported in the treatment for open tibial fractures. This study aims to compare the clinical outcomes of EF vs. ESIN in the treatment for open tibial shaft fracture in children retrospectively. Methods Patients aged 5–11 years with Gustilo-Anderson II and IIIA tibial shaft fracture treated at our institute from January 2008 to January 2018 were reviewed retrospectively and categorized into EF and ESIN groups. Patients with pathological fracture, neuromuscular disorder, metabolic disease, previous tibial fracture or instrumentation, and polytrauma were excluded. Patients with follow-up < 24 months or incomplete medical records were also excluded. Results In all, 55 patients (33 males, 22 females) were included in the EF group, whereas 37 patients (21 males, 16 females) were included in the ESIN group. There was no statistically significant difference between the two groups concerning sex, age, body weight, duration from injury to surgery, Gustilo-Anderson (GA) classification, and concomitant injuries. There was no case of nonunion and malunion in either group. The angulation at the latest follow-up was higher in the EF group than the ESIN group (P < 0.01). The radiological union was faster in the ESIN group (7.0 ± 0.9 weeks) than those in the EF group (9.0 ± 2.2 weeks) (P < 0.01). Limb length discrepancy (LLD) was more in the EF group (12.1 ± 4.4, mm) than in the ESIN group (7.3 ± 4.3, mm) (P < 0.01). Conclusion ESIN is a viable option in selected patients of GA grade II and IIIA open tibial fractures with comparable clinical outcomes as external fixator. Pin tract infection is the most troublesome complication in the EF group while implant prominence is a nuisance in the ESIN group.

show abstract

“…Open fracture of tibia is the most common injury in multiply traumatized children and receive lot of attention in the literature. 37 41 44 45 46 47 48 49 50 51 52 There is universal agreement on thorough wound debridement of Type II and Type III fractures as soon as possible. 45 Fracture can be stabilized using a range of devices including monolateral external fixators, 50 circular frames, 49 locking plates, 44 48 51 flexible nails, 47 and combination of fixators and implants.…”

Section: Open Tibial Fracturesmentioning

confidence: 99%

Management of Orthopaedic Injuries in Multiply Injured Child

Lahoti

Arya

2018

IJOO

View full text Add to dashboard Cite

Multiply injured child is a unique challenge to the medical communities worldwide. It is a leading cause of preventable mortality and morbidity in children. Common skeletal injuries include closed or open fractures of tibia and femur and pelvic injuries. Initial management focuses on saving life and then saving limb as per pediatric advanced life support and advanced trauma life support. Orthopedic management of open fracture includes splinting the limb, administration of prophylactic antibiotic, and surgical debridement of the wound when safe. However, gross contamination, compartment syndrome, and vascular injuries demand urgent attention.

show abstract

The Management of Soft Tissue and Bone Loss in Type IIIB and IIIC Pediatric Open Tibia Fractures

Abstract: Level IV.

Cited by 30 publications

References 30 publications

Operative Choice for Open Tibial Shaft Fracture in Children: A Comparative Study of External Fixator Vs. Elastic Stable Intramedullary Nail

Operative Choice for Open Tibial Shaft Fracture in Children: A Comparative Study of External Fixator Vs. Elastic Stable Intramedullary Nail

External fixation versus elastic stable intramedullary nailing in the treatment of open tibial shaft fractures in children

Management of Orthopaedic Injuries in Multiply Injured Child

Contact Info

Product

Resources

About