The Use of the Taylor Spatial Frame for the Treatment of Unstable Tibial Fractures in Children

Zenios, M.

doi:10.1097/bot.0b013e31828afb0f

Cited by 16 publications

(13 citation statements)

References 29 publications

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“…Multiple recently published reports have advocated early surgical stabilization of closed pediatric tibial fractures [2,3,5,9], citing instability of the fracture pattern, polytrauma, and failure to achieve or maintain reduction in a cast as indications. Despite this recommendation, we found no published reports directly comparing the outcomes of cast immobilization for closed pediatric tibial fractures with those of surgical stabilization.…”

Section: Discussionmentioning

confidence: 99%

Tibial shaft fractures in adolescents

Dammann

Podeszwa³

et al. 2015

Journal of Pediatric Orthopaedics B

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This study retrospectively analyzed cast treatment of 75 adolescent closed tibial diaphyseal fractures. The average age was 13.3 years (range, 10-17.4 years). Of the patients, 21% (16/75) required cast change/wedging in the clinic for loss of reduction, and three patients (4%, 3/75) injured in vehicular collisions had failure of cast treatment, requiring an unplanned surgical intervention. Initial and immediate postreduction radiographic deformities were greater (P<0.05) in patients who required cast change/wedging. Of the patients, 59% (44/75) required over 3 months of cast immobilization. Casting is successful in the majority of adolescent patients despite prolonged immobilization and the need for cast change/wedging.

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Section: Discussionmentioning

confidence: 99%

Tibial shaft fractures in adolescents

Dammann

Podeszwa³

et al. 2015

Journal of Pediatric Orthopaedics B

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“…As a result of this literature search and methodology, 12 journal articles 2 7 8 13 16 17 18 19 20 21 22 23 have been selected to undergo systematic review and critical appraisal.…”

Section: Aterials and M Ethodsmentioning

confidence: 99%

“…Most of the studies were retrospective reviews of patients’ medical records, notes, and radiographs from the databases at their respective institutions, within a time period. 13 17 18 19 21 22 23 …”

Section: R Esultsmentioning

confidence: 99%

“…Most of the other case series have stated that they included “all” of the patients meeting their criteria, so although consecutive use of patients is implied, it cannot be confirmed. 13 17 19 20 21 The remaining studies have not used consecutive patients. 18 22 23 This suggests selective use of patients, and consequently, selection bias must be considered.…”

Section: R Esultsmentioning

confidence: 99%

“…Five of the case series appraised make no mention of how the decision was made. 13 18 19 20 21 However, this may have actually been due to a lack of information in the medical records, given their retrospective nature. In a study by Buckley et al ., 23 the decision was left to the treating surgeon's discretion.…”

Section: R Esultsmentioning

confidence: 99%

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Surgical stabilization for open tibial fractures in children

Ramasubbu

2016

IJOO

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Background:Management of open tibial fractures is well documented in adults, with existing protocols outlining detailed treatment strategies. No clear guidelines exist for children. Surgical stabilization of tibial fractures in the pediatric population requires implants that do not disrupt the open epiphyses (growth plate). Both elastic stable intramedullary nails and external fixation can be used. The objective of this study was to identify the optimal method of surgical stabilization in the treatment of open tibial fractures in children.Materials and Methods:MEDLINE and Embase were searched from their inception to March 2014 using the following advanced search terms (Key words): “open tibia fracture,” “fracture fixation,” “external fixation,” “intramedullary,” and “bone nail.” Only studies in English and pertaining to children with open fractures treated with elastic stable intramedullary nails or external fixation between 1994 and 2014 were included. Twelve clinical studies were critically appraised.Results:Due to a paucity in the literature coupled with a nonsystematic presentation of results, it proved to be very difficult in extracting relevant results from the studies. This was further added by a variation in outcome measures. Consequently, the results we obtained were difficult to draw conclusions from.Conclusion:There is no conclusive evidence or best practice guidelines for their management. Thus, as is highlighted in this study, more research is needed to determine the optimum treatment strategy for this common pediatric injury. The existing literature is of poor quality; consisting mainly of retrospective reviews of patients’ medical records, charts, and radiographs. Carefully designed, high-quality prospective cohort studies utilizing a nationalized multi-hospital approach are needed to improve understanding before protocols and guidelines can be developed and implemented.

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