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European Journal of Orthopaedic Surgery & Traumatology

Erschienen in:

12.05.2021 | Expert's Opinion

Modern management of paediatric tibial shaft fractures: an evidence-based update

verfasst von: Daniel Murphy, Mohsen Raza, Fergal Monsell, Yael Gelfer

Erschienen in: European Journal of Orthopaedic Surgery & Traumatology | Ausgabe 5/2021

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Abstract

Aims

This review provides a summary of recent evidence surrounding the treatment of paediatric tibial shaft fractures and presents an algorithm to aid management of these injuries.

Summary

This article reviews the relevant anatomy, epidemiology and aetiology of tibial shaft fractures and summarises contemporary treatment principles. Management recommendations and supporting evidence are given for fractures according to age (< 18 months, 18 months–5 years, 6–12 years, and 13–18 years). The relative merits of casting, plate fixation, elastic and rigid intramedullary nailing, and external fixation are discussed. Special attention is paid to the management of open tibial shaft fractures and to complications including infection and acute compartment syndrome.

Conclusions

There has been a shift away from non-operative management of paediatric tibial shaft fractures over the last 30 years. However, recent evidence highlights that a non-operative approach produces acceptable outcomes when used in simple closed fractures at any age. Operative management may be indicated for unstable fractures where satisfactory alignment cannot be maintained or in specific circumstances including open injuries and polytrauma. Open injuries require urgent assessment by a combined orthopaedic and plastic surgery team at a specialist tertiary centre.

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Titel: Modern management of paediatric tibial shaft fractures: an evidence-based update
verfasst von: Daniel Murphy
Mohsen Raza
Fergal Monsell
Yael Gelfer
Publikationsdatum: 12.05.2021
Verlag: Springer Paris
Erschienen in: European Journal of Orthopaedic Surgery & Traumatology / Ausgabe 5/2021
Print ISSN: 1633-8065
Elektronische ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-021-02988-0

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Modern management of paediatric tibial shaft fractures: an evidence-based update

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