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paediatric tibia fracture

Swapnil Kothadia, Umesh Birole, Ashish Ranade
Fracture of talus with Salter-Harris injury of the distal end of tibia is a rare injury in paediatric age group. The authors report a case of a 13-year-old male child who sustained type IV Salter-Harris injury to the medial malleolus with coronal spilt along with spilt and depressed fracture of the neck of talus and fracture of the lateral process of talus with stable compression fracture of spine sustained due to fall from 6 meters height. CT scan delineated the morphology of fracture pattern and helped in preoperative planning...
November 27, 2017: BMJ Case Reports
S Gaukel, S Leu, L Fink, S R Skovgaard, L E Ramseier, R N Vuille-Dit-Bille
PURPOSE: The objective of this systematic review was to summarise the outcome after cast wedging due to loss of angulation in conservative fracture treatment of children's fractures. METHODS: Electronic searches were performed using MEDLINE, PubMed, OVID, CENTRAL and EMBASE without language restrictions. RESULTS: Three studies comprising 316 patients (210 radius, 52 forearm/both bone forearm fractures and 54 tibia fractures) were included in the present analysis...
October 1, 2017: Journal of Children's Orthopaedics
Wolfgang Högler, Janis Scott, Nick Bishop, Paul Arundel, Peter Nightingale, M Zulf Mughal, Raja Padidela, Nick Shaw, Nicola Crabtree
Context: Osteogenesis imperfecta (OI) is associated with reduced muscle size, dynamic muscle function, and mobility. Objective: To assess the effect of whole body vibration (WBV) on bone density and geometry, muscle size and function, mobility, and balance in children with OI. Design: Randomized controlled pilot trial. Setting: Tertiary pediatric research center. Participants: Twenty-four children (5 to 16 years) with OI types 1, 4, and limited mobility [Child Health Assessment Questionnaire (CHAQ) score ≥ 0...
August 1, 2017: Journal of Clinical Endocrinology and Metabolism
R S Nandra, F Wu, A Gaffey, C E Bache
AIMS: Following the introduction of national standards in 2009, most major paediatric trauma is now triaged to specialist units offering combined orthopaedic and plastic surgical expertise. We investigated the management of open tibia fractures at a paediatric trauma centre, primarily reporting the risk of infection and rate of union. PATIENTS AND METHODS: A retrospective review was performed on 61 children who between 2007 and 2015 presented with an open tibia fracture...
April 2017: Bone & Joint Journal
Igor Bumči, Tomislav Vlahović, Filip Jurić, Mirko Žganjer, Gordana Miličić, Hinko Wolf, Anko Antabak
BACKGROUND: Paediatric ankle fractures comprise approximately 4% of all paediatric fractures and 30% of all epiphyseal fractures. Integrity of the ankle "mortise", which consists of tibial and fibular malleoli, is significant for stability and function of the ankle joint. Tibial malleolar fractures are classified as SH III or SH IV intra-articular fractures and, in cases where the fragments are displaced, anatomic reposition and fixation is mandatory. METHODS: Type SH III-IV fractures of the tibial malleolus are usually treated with open reduction and fixation with cannulated screws that are parallel to the physis...
November 2015: Injury
Joel A Humphrey, Syed Gillani, Matthew J Barry
We report a retrospective review of all paediatric trauma patients managed with an external fixator admitted to our institution over a 7-year period. We identified 30 fractures in 28 children. The fractures included 20 tibiae, 5 femurs, 2 humerii, 2 radii and 1 phalanx. The indications were 23 open fractures, 4 comminuted fractures and 3 closed fractures in poly-traumatised patients. It was the definitive treatment in 13 fractures. The mean length of total time with an external fixator was 9.6 weeks (range 1-38 weeks...
September 2015: Acta Orthopaedica Belgica
Annelie Slaar, Ingrid H C M Karsten, Ludo F M Beenen, Mario Maas, Roel Bakx, Rick R van Rijn, Niels W L Schep
BACKGROUND AND PURPOSE: Bicycle spoke injury (BSI) mostly occurs in children as a result of entrapment of the leg in the bicycle spokes. No guideline or protocol exists that defines what type of radiography is indicated to diagnose or rule out a fracture commonly associated with these injuries. The aim of this study was (1) to evaluate the type of radiographs that are obtained in children with BSI, (2) to assess in which anatomical regions fractures occur and (3) to evaluate on which radiographs a fracture can be detected in children with BSI...
November 2015: European Journal of Radiology
Yoav Yechezkel Pikkel, Jessica Jeanne Wilson, Shokrey Kassis, Alexander Lerner
We present the case of an 8-year-old girl casualty of the Syrian conflict who arrived with open fractures of the right tibia and fibula with extensive bone and soft tissue loss as well as an open fracture of the left calcaneus as the result of a high-energy blast injury. She was successfully treated with repeated debridement procedures, external fixation with acute temporary shortening and angulation of the right leg and skin grafting to both lower limbs.
March 20, 2014: BMJ Case Reports
Ibrahim Karaman, Mehmet Halici, Ibrahim H Kafadar, Ahmet Guney, Mithat Oner, Kağan Gurbuz, Zehra F Karaman
The aim of this study was to evaluate the mid-term results of a large series of paediatric patients with long bone shaft fractures who were treated with elastic intramedullary nailing. Between November 2009 and November 2010, 108 long bone shaft fractures in 102 patients were treated with elastic intramedullary nails. The number of nails used, admission time, nail diameter/medullary canal diameter ratio of the nontraumatized extremity, weeks until radiological consolidation, weeks until full weight bearing for the femur and tibia shaft fractures, weeks until the nails were removed, number of radiographs from the diagnosis time to the removal time of nail(s), clinical complications and radiological results were recorded; the union rate, time to union, nonunion, delayed union, malrotation, malalignment, follow-up time and functional outcomes (Flynn outcome scoring) were also recorded...
May 2014: Journal of Pediatric Orthopedics. Part B
N Nicolaou, A Ghassemi, R A Hill
PURPOSE: This retrospective cohort study assesses the outcomes of a protocol of management, based on the recommendations of the European Paediatric Orthopaedic Society (EPOS) multi-centre study, for the management of congenital pseudarthrosis of the tibia. METHODS: Utilising an incremental protocol of bracing, intramedullary rods and circular frame fixation with or without bone morphogenetic protein-2 (BMP-2), 11 patients had reached skeletal maturity or had follow up of 5 years from radiological union of the pseudarthrosis...
October 2013: Journal of Children's Orthopaedics
Aamer Nisar, Abhijit Bhosale, Sanjeev S Madan, Mark J Flowers, James A Fernandes, Stanley Jones
This study reports the complications observed in children with long bone fractures treated using Elastic Stable Intramedullary Nailing (ESIN). One hundred and sixty-four (n = 164) fractures in 160 patients under the age of 16 years formed the basis of our review. This included 108 boys and 52 girls with the median age of 11 years and median follow up of 7.5 months. The analysis included fractures of the radius/ulna, humerus, femur and tibia. All pathological fractures were excluded. In this series 54 patients (34%) had complications however majority of these were minor complications with irritation due to prominent nail ends being the commonest complication...
2013: Journal of Orthopaedics
A Celarek, S F Fischerauer, A M Weinberg, E K Tschegg
Fractures of the growth plate region were performed with cadaver specimens obtained from the ovine distal femur and proximal tibia. Specimens of 6 different ages, ranging from 1 week to 4 years, were investigated in order to determine changes in the fracture characteristics. Mechanical properties (crack resistance and notch tensile strength), supported by microscopy of the distal tibia (thickness of growth plate and its zones, trabecular bone volume ratio) were determined. The crack propagated through different regions depending on age, which was observed both in microscopy and mechanical tests...
January 2014: Journal of the Mechanical Behavior of Biomedical Materials
Adrian Chong Beng Tan, Roland Weng Wah Chong, Arjandas Mahadev
PURPOSE: To review 28 cases of paediatric triplane fractures of the distal tibia over a 7-year period in a tertiary paediatric hospital. METHODS: Records of 21 boys and 7 girls aged 11 to 15 (mean, 13) years presented with triplane fractures of the left (n=14) and right (n=14) ankles were retrospectively reviewed. RESULTS: Injury mechanism included low-energy trauma (n=10) and moderate-energy trauma (n=18). Fractures were 2-part in 20 patients, 3-part in 6, and 4-part in 2...
April 2013: Journal of Orthopaedic Surgery
Andrew Biggin, Julie N Briody, Kim A Ramjan, Anna Middleton, Mary-Clare A Waugh, Craig F Munns
OBJECTIVE: To evaluate the effects of spinal cord injury (SCI) on bone density and morphology in children using peripheral quantitative computer tomography (pQCT). DESIGN: Retrospective cohort study of 19 paediatric patients with SCI (9 paraplegics and 10 tetraplegics). RESULTS: There was significant reduction in tibial metaphysial volumetric bone mineral density (vBMD), diaphysial cortical cross-sectional area (CSA), cortical thickness and polar strength-strain index...
December 2013: Developmental Neurorehabilitation
Guru Dayal Singh Kalra, Amit Agarwal
BACKGROUND: Congenital pseudarthrosis is one of the greatest challenges of paediatric orthopaedic practice. Treatment options and literature addressing this condition are numerous, reflecting the difficulty in management. We aimed to study the effectiveness of free fibula transfer as a primary modality of treatment in children with this condition in terms of achieving length, union, and normal axis of the involved leg. MATERIALS AND METHODS: During the period of 2001 to 2010, 26 children with congenital pseudarthrosis of tibia between age group of 2-8 years were evaluated and were reconstructed using contra-lateral free fibula graft, and then patients were followed up for 5 years subsequently...
September 2012: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
Ilaria Riccio, Marco Marcarelli, Nicola Del Regno, Claudia Fusco, Martina Di Martino, Raffaele Savarese, Giovanna Gualdiero, Matilde Oreste, Cristiana Indolfi, Giovanni Porpora, Marco Esposito, Fiorina Casale, Giovanni Riccardi
Acute leukemia (AL) in children can mimic several orthopedic pathologies at presentation, with a variable delay in the correct diagnosis. This is a major problem, which may result in fractures, loss of mobility, and deformity, with resultant adverse effects on quality of life. Here, we studied the clinical and radiological musculoskeletal manifestations in children with AL. We reviewed 328 children [208 boys (62%), median age 7.2 years] with acute lymphoblastic (279, 85%) or myeloid (49, 15%) leukemia, treated between January 1982 and December 2003 by the Paediatric Oncology Service, Second University of Naples...
May 2013: Journal of Pediatric Orthopedics. Part B
H Vinz, O-A Festge, J Neu
BACKGROUND: Statistics of the Arbitration Office of the North German Medical Boards for extrajudicial claim resolution show that nearly 30 % of all panel proceedings confirm medical malpractice. In proceedings concerning fractures in children the percentage rises to 63 % with significant differences in various fracture localisations. METHODS: Between 2000 and 2011 the Arbitration Office dealt with 272 panel proceedings regarding the fracture treatment in children...
December 2012: Zeitschrift Für Orthopädie und Unfallchirurgie
Bingshu He, Jun Wang
The role of surgery in the management of paediatric long-bone shaft fractures remains a matter of debate. We present a series of paediatric patients with unstable fractures of the distal tibia and fibula, treated with titanium plate fixation. Excellent results were obtained after plate fixation.
October 2012: Acta Orthopaedica Belgica
Ann-Maria Byrne, Michael Stephens
Paediatric talus fractures are rare injuries resulting from axial loading of the talus against the anterior tibia with the foot in dorsiflexion. Skeletally immature bone is less brittle, with higher elastic resistance than adult bone, thus the paediatric talus can sustain higher forces before fractures occur. However, displaced paediatric talus fractures and those associated with high-energy trauma have been associated with complications including avascular necrosis, arthrosis, delayed union, neurapraxia and the need for revision surgery...
May 8, 2012: BMJ Case Reports
Luisella Pedrotti, Barbara Bertani, Gabriella Tuvo, Francesca Barone, Ilaria Crivellari, Stefano Lucanto, Mora Redento
The evolution of medical and surgical therapies allows the increased survival rate of a growing number of children affected by rare pathologies. In this light osteoporotic disease is also of orthopaedic interest as it is sometimes the outward manifestation of serious pathologies (i.e. osteogenesis imperfecta). Sometimes, even in infancy and adolescence, osteoporosis is associated with complications due to fractures; in other cases it seems to have no immediate consequence. Nevertheless it must be considered as a fracture risk factor in adulthood as it negatively affects the achievement of peak bone mass...
May 2010: Clinical Cases in Mineral and Bone Metabolism
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