Pediatric tibial shaft and distal metaphyseal fractures
Osman Civan1, Bahadır Alimoğlu1, Mustafa İçen1, Selim Taşkın1, Ali Cavit2, Yetkin Söyüncü1, Mustafa Ürgüden1
1Department of Orthopedics and Traumatology, Medicine Faculty of Akdeniz University, Antalya, Turkey
2Department of Orthopedics and Traumatology, Medicine Faculty of Uludağ University, Bursa, Turkey
Keywords: Non-union, pediatric fractures, pediatric tibial fractures, tibial fractures, union.
Objectives: This study aims to investigate the effects of associated factors like age, fracture level, accompanying fibular fractures and wound condition on healing by determining and comparing union scores of pediatric tibial fractures (PTFs).
Patients and methods: Forty-five patients with 46 PTFs (32 males, 13 females; mean age 9.5 years; range 2 to 16 years) who were treated by closed reduction and casting or operated between January 2016 and January 2019 were retrospectively evaluated. The union scores were evaluated at the end of fourth, sixth and eighth weeks and compared to each other. Effects of the age, associated fibular fractures, wound condition, fracture level and treatment type to union score were analyzed.
Results: Twenty-eight (60.9%) out of 46 PTFs had associated fibular fractures and 18 (39.1%) did not. Motor vehicle accident was the most frequent etiologic factor (47.8%). Thirty-four out of 46 fractures were closed tibial fractures (73.9%) and 12 had open wound (26.1%). There was a negative correlation between age and the union scores (p<0.001 for each week). No significant difference was observed between the union score of diaphyseal and metaphyseal fractures at the fourth, sixth, and eighth weeks. The union scores of each week were higher in the conservative group compared to operative group (p<0.001 for each week). Associated fibular fracture group had lower union scores compared to isolated tibial fracture group at fourth, sixth and eighth weeks. Likewise, the union scores of the open fracture group were lower than the closed fracture group (p<0.05 for each week).
Conclusion: Associated fibular fractures, open fractures and aging negatively affect union scores of PTFs. Attention should be paid, particularly in these conditions, during the selection of the operation type and the follow-up period of PTFs.
The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.
The authors received no financial support for the research and/or authorship of this article.
Special thanks to Dr. Deniz Özel Erkan and Akdeniz University Statistical Advisory Unit.