Category Ranking
98%
Total Visits
921
Avg Visit Duration
2 minutes
Citations
20
Article Abstract
Background: Tibial fractures are the most common musculoskeletal injury in adolescents. The optimal management of tibial fractures in adolescents is controversial. In this study, we compared the outcomes including complications of three fixation methods in tibial fractures of adolescents and explored the factors associated with the complications.
Methods: A retrospective cohort study about 83 diaphyseal tibial fractures in 79 children and adolescents, who were treated with plate fixation (PF), elastic stable intramedullary nail fixation (ESINF), or external fixation (EF), was conducted. After adjustment for age, weight, energy of the injury, polytrauma, fracture level and pattern, and extent of comminution, treatment outcomes were compared in accordance with the length of the hospital stay, time to union, and complication rates including many factors.
Results: The mean age of the patients was 13.4 years, and their mean weight was 44.2 kg. There was a loss of reduction in two of 33 fractures treated with ESINF and four of 13 treated with EF (P < 0.001). At the time of final follow-up, three patients (two treated with EF and one treated with ESINF) had ≥2.0 cm of shortening. Four of the 32 patients (33 fractures) treated with ESINF underwent a reoperation (two due to loss of reduction and one each because of delayed union and nonunion). Six patients treated with EF required a reoperation (four due to loss of reduction, one for malunion and one for replacement of a pin complicated by infection). Two fracture treated with PF required refixation attributing to nonunion and malunion. A multivariate analysis with adjustment for baseline differences showed that EF was associated with a 7.56-times (95% confidence interval 3.74-29.87) greater risk of loss of reduction and/or malunion than ESINF.
Conclusions: All three treatments had satisfactory outcomes, and EF was correlated with the highest rate of complications in our series of adolescents treated with a tibial fracture. However, we cannot currently recommend that all fractures might be suitable for ESINF. The choice of fixation will remain influenced by surgeon preference in term of expertise and experience, patient and fracture characteristics, and patients and family preferences.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1111/ans.14258 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Early versus Delayed Plate Fixation in Pilon Fractures.
J Am Podiatr Med Assoc
September 2025
§Aybars Kıvrak Orthopedics Clinic, Adana, Turkey.
Background: Pilon fractures refer to distal tibial fractures that may involve extra-articular, partial articular, or complete intra-articular components, most commonly caused by high-energy trauma. The choice between early (<72 hours) and delayed (>7 days) surgical fixation significantly impacts clinical outcomes. This study aimed to compare the effects of early vs.
View Article and Find Full Text PDFThe Fallacy of Patient-Reported Outcome Measures: Why They Often Fail to Detect Clinically Important Differences.
JB JS Open Access
September 2025
Center for Orthopaedic Injury Research and Innovation, Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland.
Background: Patient-reported outcome measures are increasingly common in orthopaedic research yet routinely fail to detect clinically meaningful differences in clinical trials. We assessed if orthopaedic studies are more likely to detect clinically important differences with a binary outcome, such as nonunion surgery, or a continuous patient-reported outcome sensitive to important clinical differences.
Methods: We constructed a hypothetical clinical trial comparing 2 treatments for tibial shaft fractures.
Open Tibial Fractures Part 1: A Narrative Review of Initial Treatment and Potential Applicability to the Southern African Context.
Orthop Res Rev
September 2025
Department of Orthopaedic Surgery, The Royal Brisbane and Women's Hospital, Brisbane, Australia.
Treatment guidelines for open tibial fractures are well established in high-income countries, but their implementation in low-resource settings remains challenging. To date, only one African country has attempted to formulate national, consensus-based guidelines that cover key aspects such as antibiotic administration, initial stabilization, surgical debridement, wound management, and definitive fixation. This narrative review summarizes current principles for the initial management of open tibial shaft fractures and evaluates their relevance in the Southern African context, particularly in rural and resource-constrained environments.
View Article and Find Full Text PDFThe Role of Immediate Arthroplasty in Elderly Tibial Plateau Fractures.
Orthop Rev (Pavia)
September 2025
Introduction/background: Complex articular fractures around the knee in the elderly patient present an ongoing challenge regarding optimal treatment. While extensive research has evaluated immediate arthroplasty following fracture of the proximal femur, distal femur, proximal humerus, and elbow, relatively little focus has been given to immediate arthroplasty following complex tibia plateau fractures.
Methods: As seen with many other fractures, arthroplasty can shorten recovery and hospital stay and allow early weight-bearing with improved mobility while minimizing complications and possible future conversion arthroplasty cost.
Risk Factors of Surgical Site Infection After Adult Closed Tibial Plateau Fractures Treated by Open Reduction and Internal Fixation.
Infect Drug Resist
August 2025
Department of Orthopedic Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China.
Background: Surgical site infection (SSI) after surgery can cause serious sequelae in patients with tibial plateau fractures. This study aims to report the incidence and characteristics of SSI and to investigate the risk factors of SSI in adult patients with closed tibial plateau fracture, especially the relationship between SSI and preoperative hypoalbuminemia.
Methods: We retrospectively reviewed the records of adult patients with closed tibial plateau fracture who were treated at our institution from January 2016 to December 2022.