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Abstract
The results of the treatment of open tibial fractures in 58 children aged between
3 and 15 years are reviewed. There were 25 Gustilo Type I, 22 Type II and 10 Type
III fractures. At operation 37 wounds were closed primarily and 21 wounds were left
open. Of these 21, 13 healed by secondary intention and eight required split skin
grafting or soft tissue flap coverage. Stable fractures were immobilized in an above-knee
plaster in 48 cases (83 per cent) and six fractures treated with external fixation
(10 per cent). Two patients (3.5 per cent) had cast immobilization of the tibial fracture
and traction for an ipsilateral femoral fracture. Two patients (3.5 per cent) with
Gustilo Type IIIc injuries required an amputation, one ‘de novo’ as the limb was not salvageable and one 4 days after failed vascular reconstruction.
All fractures healed primarily without bone grafting, although there were three cases
of delayed union and seven cases of malunion. Six children had superficial wound infections
but there were no cases of deep infection or osteomyelitis. There was one case of
compartment syndrome.
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References
- Fractures of the tibia in children.Acta Orthop Scand. 1976; 47: 448
- Open fractures of the tibia in children.J Bone Joint Surg [Am]. 1990; 72A: 1462
- Open fractures of the diaphysis of the lower extremity in children.J Bone Joint Surg [Am]. 1992; 74A: 218
- Open fractures of the tibia in children.J Bone Joint Surg [Br]. 1992; 74B: 546
- Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bones.J Bone Joint Surg [Am]. 1976; 58A: 453
- Problems in the management of type III open fractures.J Trauma. 1984; 24: 742
- Classification of type III (severe) open fractures relative to treatment and results.Orthopedics. 1987; 10: 1781
- Open tibial fractures in children.Orthop Trans. 1989; 13: 547
Article info
Publication history
Accepted:
July 26,
1994
Identification
Copyright
© 1995 Published by Elsevier Inc.
