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Year : 2018  |  Volume : 52  |  Issue : 5  |  Page : 522-528

Pediatric tibial shaft fractures

Department of Orthopaedic Surgery, Virginia Commonwealth University, Richmond, VA, USA

Correspondence Address:
Dr. Varatharaj Mounasamy
Department of Orthopaedic Surgery, Virginia Commonwealth University, West Hospital, 1200 East Broad Street, P. O. Box 980153, Richmond, Virginia 23298
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ortho.IJOrtho_486_17

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Tibial shaft fractures are one of the most common pediatric fractures. They require appropriate diagnosis and treatment to minimize complications and optimize outcomes. Diagnosis is clinical and radiological, which can be difficult in a young child or with minimal clinical findings. In addition to acute fracture, Toddler's and stress fractures are important entities. Child abuse must always be considered in a nonambulatory child presenting with an inconsistent history or suspicious concomitant injuries. Treatment is predominantly nonoperative with closed reduction and casting, requiring close clinical and radiological followup until union. Although there is potential for remodeling, this may not be adequate with more significant deformities, thus requiring remanipulation or rarely, operative intervention. This includes flexible intramedullary nailing, Kirschner wire fixation, external fixation, locked intramedullary nailing, and plating. Complications are uncommon but include deformity, growth arrest, nonunion, and compartment syndrome.

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