Quality of life and post-traumatic stress symptoms in paediatric patients with tibial fractures during treatment with cast or Ilizarov frame

Johnson, Louise; Messner, Juergen; Igoe, E.J.; Foster, Patrick; Harwood, Paul

doi:10.1016/j.injury.2019.10.077

Cited by 6 publications

(6 citation statements)

References 25 publications

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“…Previous studies (Bicen et al, 2021 ; Eckert et al, 2020 ) have pointed out that pain is an unpleasant emotional experience. At the same time, it can also be used as a source of stress to cause patients to produce other adverse emotional experiences, and cause patients to produce varying degrees of acute stress responses by affecting emotions, cognition, and physiological and psychological processes (Johnson et al, 2020 ). It is suggested that it is very necessary to take corresponding measures to reduce pain to improve the patient’s discomfort and relieve the irritation, depression and other negative emotions caused by pain in the process of clinical care(Nayak et al, 2019 ).…”

Section: Discussionmentioning

confidence: 99%

Acute stress disorder in patients with accidental traumatic fractures: What can we do

Liang

Tang

et al. 2022

Nursing Open

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Aim To evaluate the potential influencing factors of acute stress disorder (ASD) in patients with accidental traumatic fractures to provide evidence for clinical nursing care. Design A retrospective study. Methods Patients with traumatic fractures treated in our hospital from 1 January 2020 to 30 November 2021 were included. The characteristics of ASD and no ASD patients were assessed. Results A total of 468 patients with traumatic fractures were included, the incidence of ASD was 28.20%. Logistic regression analysis showed that age ≤50 years (OR2.918, 95% CI1.994 ~ 3.421), female (OR2.074, 95% CI1.489 ~ 3.375), AIS‐ISS at admission ≥20 (OR3.981, 95% CI2.188 ~ 5.091), VAS at admission≥7 (OR2.804, 95% CI2.027 ~ 3.467), introverted personality (OR1.722, 95%CI1.314 ~ 2.432) and CD‐RISC at admission≤60 (OR3.026, 95% CI2.338 ~ 4.769) were the risk factors of ASD in patients with traumatic fractures (all p < .05). Conclusions The development of ASD in patients with traumatic fractures is affected by multiple factors. Medical workers should take early and timely management and nursing measures for related risk factors to reduce the occurrence of ASD.

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Section: Discussionmentioning

confidence: 99%

Acute stress disorder in patients with accidental traumatic fractures: What can we do

Liang

Tang

et al. 2022

Nursing Open

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“…Our experience is that most patients who are approaching the end of their frame treatment seem to function very well, and so remaining in the frame a little longer does not appear to have any signifcant psychological or physical consequence. 9 This approach could also be justified based on our positive outcomes and low complication rate. Donnan et al’s 8 cohort had a comparable rate of problems, obstacles, and complications in that 50% of patients developed a superficial pin-site infection, with 27% being treated with oral antibiotics, 14% with intravenous antibiotics, and 10% with wire removal.…”

Section: Discussionmentioning

confidence: 99%

Distal tibial osteotomy compared to proximal osteotomy for limb lengthening in children

Chowdhury

Ahmadi

Prior

et al. 2022

The Bone & Joint Journal

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Aims The aim of this retrospective cohort study was to assess and investigate the safety and efficacy of using a distal tibial osteotomy compared to proximal osteotomy for limb lengthening in children. Methods In this study, there were 59 consecutive tibial lengthening and deformity corrections in 57 children using a circular frame. All were performed or supervised by the senior author between January 2013 and June 2019. A total of 25 who underwent a distal tibial osteotomy were analyzed and compared to a group of 34 who had a standard proximal tibial osteotomy. For each patient, the primary diagnosis, time in frame, complications, and lengthening achieved were recorded. From these data, the frame index was calculated (days/cm) and analyzed. Results All patients ended their treatment with successful lengthening and deformity correction. The frame index for proximal versus distal osteotomies showed no significant difference, with a mean 48.5 days/cm (30 to 85) and 48.9 days/cm (28 to 81), respectively (p = 0.896). In the proximal osteotomy group, two patients suffered complications (one refracture after frame removal and one failure of regenerate maturation with subsequent valgus deformity) compared to zero in the distal osteotomy group. Two patients in each group sustained obstacles that required intervention (one necessitated guided growth, one fibula lengthening, and two required change of wires). There was a similar number of problems (pin-site infections) in each group. Conclusion Our data show that distal tibial osteotomies can be safely employed in limb lengthening for children using a circular frame, which has implications in planning a surgical strategy; for example, when treating a tibia with shortening and distal deformity, a second osteotomy for proximal lengthening is not required. Cite this article: Bone Joint J 2022;104-B(11):1273–1278.

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“…It has been our experience that these are well tolerated in patients in this age range, but there is interference with certain tasks, particularly washing, sleeping, and dressing. 5 Small numbers of patients find living with the fixators psychologically distressing, and this should be considered when assessing for different treatment options. 6 Once united, internal fixation implants are removed, in a pediatric population usually, particularly in the lower limb.…”

Section: Discussionmentioning

confidence: 99%

Complex Tibial Shaft Fractures in Children Involving the Distal Physis Managed with the Ilizarov Method

Rogers

Tan

Foster

et al. 2014

Strategies in Trauma and Limb Reconstruction

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Introduction: Segmental fractures in the juvenile distal tibia with physeal involvement present specific challenges. Injury to the growth plate may be overlooked, potentially resulting in late sequelae. Fracture stabilization can be complex. Previous reports of management of such an injury are by open reduction and internal fixation. This study reviews the management and outcome of a group of such patients treated with Ilizarov external fixators. Materials and methods: Patients aged 16 or younger treated in our unit between March 2013 and November 2014 by Ilizarov circular fine wire fixation for tibial fractures with ipsilateral physeal injuries were identified. Retrospective collection of patient demographics, fracture classification, treatment pathways, fixation methods, postoperative follow-up, outcomes, and complications was undertaken. Results: Eight patients were identified; two had Gustilo and Anderson grade IIIA open injuries. All were managed definitively using an Ilizarov external fixator in combination with percutaneous screw fixation of the physeal component as required. All patients were ambulant during treatment and were allowed unrestricted weight-bearing immediately postoperative. All but one attended school. All fractures united. In follow-up, one patient had a distal tibial physeal growth arrest, but there were no other complications. Conclusion: Pediatric patients with complex distal tibial fractures should be scrutinized for concomitant physeal injury. Where identified treatment, using a combination of internal fixation and an Ilizarov fixator can be considered.

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Quality of life and post-traumatic stress symptoms in paediatric patients with tibial fractures during treatment with cast or Ilizarov frame

Cited by 6 publications

References 25 publications

Acute stress disorder in patients with accidental traumatic fractures: What can we do

Acute stress disorder in patients with accidental traumatic fractures: What can we do

Distal tibial osteotomy compared to proximal osteotomy for limb lengthening in children

Complex Tibial Shaft Fractures in Children Involving the Distal Physis Managed with the Ilizarov Method

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