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tibial fractures in children

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https://www.readbyqxmd.com/read/29666001/distal-tibial-triplane-fracture-with-ipsilateral-tibial-shaft-fracture-a-case-series
#1
Timothy S Holland, Christopher P Prior, Roger Dm Walton
BACKGROUND & PURPOSE: Distal tibial Triplane fracture with ipsilateral tibial shaft fracture is a rare but important problem. This rarely reported combination of injuries if not recognised may lead to deleterious consequences. METHODS/PATIENTS: The local database of all emergency admissions was scrutinised to identify subjects before interrogation of the clinical notes and relevant radiographic imaging. FINDINGS: This paper reports a series of five children who were found to have triplane fracture of the distal tibia with concomitant ipsilateral fracture of the tibial shaft...
April 14, 2018: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/29629581/vascularized-fibular-epiphyseal-transfer-for-proximal-humeral-reconstruction-in-children-with-a-primary-sarcoma-of-bone
#2
J D Stevenson, R Doxey, A Abudu, M Parry, S Evans, F Peart, L Jeys
Aims Preserving growth following limb-salvage surgery of the upper limb in children remains a challenge. Vascularized autografts may provide rapid biological incorporation with the potential for growth and longevity. In this study, we aimed to describe the outcomes following proximal humeral reconstruction with a vascularized fibular epiphyseal transfer in children with a primary sarcoma of bone. We also aimed to quantify the hypertrophy of the graft and the annual growth, and to determine the functional outcomes of the neoglenofibular joint...
April 1, 2018: Bone & Joint Journal
https://www.readbyqxmd.com/read/29600218/arthroscopic-fixation-of-tibial-spine-avulsion-in-skeletally-immature-the-technique
#3
Skand Sinha, Durgashankar Meena, Ananta K Naik, M Selvamari, Rajendra K Arya
Introduction: Tibial spine avulsion fracture is more frequent in children than adults. Various methods of fixation have been mentioned, but concern remains about crossing the tibial physis. We present a technique of arthroscopic fixation with non-absorbable suture. Case Report: A total of 10 skeletally immature patients with tibial spine avulsion of Meyers and McKeever Type 2 and 3 were included in the study. The knee was arthroscopically cleared of hematoma. The avulsed tibial insertion of anterior cruciate ligament was reduced and held in place with tibial guide...
November 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/29589503/treatment-and-functional-outcomes-of-complex-tibial-fractures-in-children-and-adolescents-using-the-ilizarov-method
#4
J Messner, L Johnson, D M Taylor, P Harwood, S Britten, P Foster
Aims The aim of this study was to report the clinical, functional and radiological outcomes of children and adolescents with tibial fractures treated using the Ilizarov method. Patients and Methods Between 2013 and 2016 a total of 74 children with 75 tibial fractures underwent treatment at our major trauma centre using an Ilizarov frame. Demographic and clinical information from a prospective database was supplemented by routine functional and psychological assessment and a retrospective review of the notes and radiographs...
March 1, 2018: Bone & Joint Journal
https://www.readbyqxmd.com/read/29549568/cozen-s-deformity-resolved-by-guided-growth
#5
Matthew Morin, Joshua Klatt, Peter M Stevens
Proximal tibial metaphyseal fractures in children can lead to progressive and symptomatic tibial valgus. Corrective osteotomy has been abandoned, due to frequent complications, including recurrent valgus deformity. While spontaneous remodelling has been reported, this is not predictable. For children with persistent deformities, we have resorted to guided growth of the tibia. We present 19 patients who were successfully treated with guided growth, tethering the proximal medial physis. There were ten boys and nine girls, ranging in age from two to 13...
March 16, 2018: Strategies in Trauma and Limb Reconstruction
https://www.readbyqxmd.com/read/29529639/what-are-the-complications-of-allograft-reconstructions-for-sarcoma-resection-in-children-younger-than-10-years-at-long-term-followup
#6
Luis A Aponte-Tinao, Jose I Albergo, Miguel A Ayerza, D Luis Muscolo, Federico Milano Ing, German L Farfalli
BACKGROUND: Preservation of limb function after resection of malignant bone tumors in skeletally immature children is challenging. Resection of bone sarcomas and reconstruction with an allograft in patients younger than 10 years old is one reconstructive alternative. However, long-term studies analyzing late complications and limb length discrepancy at skeletal maturity are scarce; this information would be important, because growth potential is altered in these patients owing to the loss of one physis during tumor resection...
March 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29516235/management-of-a-type-two-avulsion-fracture-of-the-tibial-intercondylar-eminence-in-children-arthroscopic-suture-fixation-versus-conservative-immobilization
#7
Chen Zhao, Qing Bi, Mingguang Bi
BACKGROUND: Treatment of a type II tibial eminence avulsion fracture was controversial. The aim of this study was to compare the clinical outcomes of a modified arthroscopic suture fixation versus conservative immobilization in treatment of this type fracture in immature population. METHODS: A total of 43 type II avulsion fractures of tibial intercondylar eminence in immature patients were retrospectively enrolled in the study. Twenty-two (13 males, 9 females) were treated with arthroscopic suture fixation and 21(12 males, 9 females) with conservative cast immobilization...
March 7, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29514377/proximal-tibial-fractures-in-the-pediatric-population
#8
Kali Tileston, Steven Frick
Injuries about the proximal tibia are quite common in children. Understanding the mechanisms of injury and treatment strategies is imperative for practitioners caring for these patients. Similarly, appreciating the anatomy of the proximal tibia and the adjacent neurovascular structures can assist a practitioner in recognizing the potential associated risks following fracture. Patients with injuries about the proximal tibia require long-term follow-up, and knowledge of the natural history of these fractures is imperative...
March 7, 2018: Journal of Knee Surgery
https://www.readbyqxmd.com/read/29514374/tibial-spine-fractures-in-children-evaluation-management-and-future-directions
#9
Alexander J Adams, Nakul S Talathi, Jigar S Gandhi, Neeraj M Patel, Theodore J Ganley
Fractures of the tibial spine are estimated to occur in 3 per 100,000 children annually, but account for 2 to 5% of pediatric knee injuries with effusion. Although these fractures were historically associated with bicycle accidents, the surge of organized youth sports in recent decades has brought renewed attention to this injury. While minimally displaced fractures can be treated nonoperatively, several techniques have been described for fixation of displaced or comminuted fractures. Sequelae of this injury can include arthrofibrosis, knee instability, and nonunion...
March 7, 2018: Journal of Knee Surgery
https://www.readbyqxmd.com/read/29463853/spina-bifida-predisposing-heterozygous-mutations-in-planar-cell-polarity-genes-and-zic2-reduce-bone-mass-in-young-mice
#10
Isabel R Orriss, Stuart Lanham, Dawn Savery, Nicholas D E Greene, Philip Stanier, Richard Oreffo, Andrew J Copp, Gabriel L Galea
Fractures are a common comorbidity in children with the neural tube defect (NTD) spina bifida. Mutations in the Wnt/planar cell polarity (PCP) pathway contribute to NTDs in humans and mice, but whether this pathway independently determines bone mass is poorly understood. Here, we first confirmed that core Wnt/PCP components are expressed in osteoblasts and osteoclasts in vitro. In vivo, we performed detailed µCT comparisons of bone structure in tibiae from young male mice heterozygous for NTD-associated mutations versus WT littermates...
February 20, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29456750/paediatric-tibial-shaft-fractures-treated-by-open-reduction-and-stabilization-with-monolateral-external-fixation
#11
A-L Simon, N Apostolou, C Vidal, E Ferrero, K Mazda, B Ilharreborde
Purpose: Elastic stable intramedullary nailing is increasingly used for surgical treatment of tibial shaft fractures, but frequently requires immobilization and delayed full weight-bearing. Therefore, external fixation remains interesting. The aim was to report clinico-radiological outcomes of monolateral external fixation for displaced and unstable tibial shaft fractures in children. Methods: All tibial fractures consecutively treated by monolateral external fixation between 2008 and 2013 were followed...
February 1, 2018: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/29409477/clinical-and-radiological-outcomes-of-arthroscopically-assisted-cannulated-screw-fixation-for-tibial-eminence-fracture-in-children-and-adolescents
#12
Chang Ho Shin, Doo Jae Lee, In Ho Choi, Tae-Joon Cho, Won Joon Yoo
BACKGROUND: The purpose of this study was to determine the efficacy and complications of arthroscopically assisted reduction and fixation with cannulated screws for tibial eminence fracture in skeletally immature patients. METHODS: This was a retrospective case series study. Forty-eight patients who were skeletally immature at the time of tibial eminence fracture were treated in a tertiary children's hospital between May 2004 and August 2015. Twenty-one patients were excluded due to non-operative treatment (n = 10), other surgical treatments (n = 9), multiple fracture (n = 1), and follow-up < 1 year (n = 1)...
February 6, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29407250/comparison-of-the-outcomes-of-pediatric-tibial-shaft-fractures-treated-by-different-types-of-orthopedists-a-prospective-cohort-study
#13
Wenhao Zheng, Chunhui Chen, Zhenyu Tao, Chuanxu Zhang, Hui Zhang, Hang Li, Zhenhua Feng, Liang Cheng, Hua Chen
BACKGROUND: The objective of this study was to compare the outcomes of pediatric tibial shaft fractures treated with titanium elastic nail (TEN) by pediatric orthopedists and non-pediatric orthopedists. MATERIALS AND METHODS: We conducted a prospective cohort study of 90 children of tibial shaft fractures, who were randomized to operative stabilization either by pediatric orthopedists (Group A, 45 cases) or by non-pediatric orthopedists (Group B, 45 cases) from April 2010 to May 2015...
January 30, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29365222/heel-pain-diagnosis-and-management
#14
Priscilla Tu
The differential diagnosis of heel pain is extensive, but a mechanical etiology is the most common. The specific anatomic location of the pain can help guide diagnosis. The most common diagnosis is plantar fasciitis, which leads to medial plantar heel pain, especially with the first weight-bearing steps after rest. Other causes of plantar heel pain include calcaneal stress fractures (progressively worsening pain after an increase in activity or change to a harder walking surface), nerve entrapment or neuroma (pain accompanied by burning, tingling, or numbness), heel pad syndrome (deep, bruise-like pain in the middle of the heel), and plantar warts...
January 15, 2018: American Family Physician
https://www.readbyqxmd.com/read/29330745/-treatment-of-rotational-malalignment-of-the-lower-leg
#15
REVIEW
P Keppler
BACKGROUND: Rotational malalignment after intramedullary nailing of tibial shaft fractures is not uncommon. In-toeing and out-toeing conditions in children are often the reason for orthopedic and traumatological medical consultation. OBJECTIVE: Evaluation of diagnostic modalities and therapeutic options for rotational malalignment in relationship to the patient's age. Surgical indications and efficacy of specific surgical techniques. MATERIAL AND METHODS: Systematic literature search in the German Institute for Medical Documentation and Information (DIMDI) and MEDLINE and evaluation of the currently published articles...
March 2018: Der Unfallchirurg
https://www.readbyqxmd.com/read/29159851/comparison-of-three-fixation-methods-in-treatment-of-tibial-fracture-in-adolescents
#16
REVIEW
Lixiang Lin, Yang Liu, Chuanlu Lin, Yifei Zhou, Yongzeng Feng, Xiaolong Shui, Kehe Yu, Xiaolang Lu, Jianjun Hong, Yang Yu
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...
November 21, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29141620/treatment-of-genu-valgum-in-children-by-means-of-temporary-hemiepiphysiodesis-using-eight-plates-short-term-findings
#17
Dirk Zajonz, Eckehard Schumann, Magdalena Wojan, Fabian B Kübler, Christoph Josten, Ulf Bühligen, Christoph E Heyde
BACKGROUND: Idiopathic genu valgum is a frequently diagnosed growth disorder in adolescence. Whenever the possibilities of conservative therapy have been exhausted, leg straightening by means of hemiepiphysiodesis has become the standard form of treatment. Because of their flexible screw-plate connection, eight-Plates have been reported in the literature to lead to lower complications regarding implant loosening and fracture compared to other implants. The aim of this retrospective survey was to analyse our own patient population who were treated for genu valgum by means of temporary hemiepiphysiodesis near the knee using eight-Plates to modulate growth...
November 15, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29053502/the-community-orthopaedic-surgeon-taking-trauma-call-pediatric-ankle-fracture-pearls-and-pitfalls
#18
Shital N Parikh, Charles T Mehlman
Pediatric ankle fractures are common and have unique fracture characteristics because of the presence of distal tibial and fibular physes. When displaced (>3 mm widening of the physis or >2 mm intra-articular gap/step-off), these fractures are typically treated with anatomical reduction and internal fixation. Computed tomography is recommended for preoperative evaluation and surgical planning for intra-articular fractures. These fractures in younger children with substantial growth remaining should be followed closely to monitor for any growth disturbance...
November 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29053501/the-community-orthopaedic-surgeon-taking-trauma-call-pediatric-tibia-fracture-pearls-and-pitfalls
#19
Steven A Lovejoy, Charles T Mehlman
Tibial fractures in children present a wide array of challenges to the managing orthopaedic surgeon. Injuries cover a spectrum from subtle tibial spine fractures to comminuted high-energy shaft fractures requiring free flap coverage. Significant risks range from malunion and leg length discrepancy to infected nonunions and Volkmann ischemic contracture. This article offers evidence and experience-based advice that is aimed at helping the community orthopaedic surgeon taking call.
November 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29025614/outcome-of-distal-tibia-physeal-fractures-a-review-of-cases-as-related-to-risk-factors
#20
Fabio D'Angelo, Giuseppe Solarino, Davide Tanas, Alessia Zani, Paolo Cherubino, Biagio Moretti
INTRODUCTION: The physeal fractures represent the 20-30% of all fractures of the child. The distal tibial physis is the third most frequently injured. The most important complication is the premature physeal closure (PPC). Aim of this study is to evaluate risk factors that can influence the outcome like fracture pattern, fracture displacement, mechanism of injury and treatment method. MATERIAL AND METHODS: The records of 46 patients treated for distal tibia physeal fractures between 2003 and 2013 were reviewed...
October 2017: Injury
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