Abstract
Abstract
Background
This study was performed to investigate leg length discrepancy (LLD), overgrowth, and associated risk factors after pediatric tibial shaft fractures.
Materials and methods
This study included 103 patients younger than 14 years of age (mean age 7.1 years; 75 boys, 28 girls) with unilateral tibial shaft fracture and a minimum follow-up of 24 months. LLD was calculated as the difference between the lengths of the injured and uninjured limbs. Overgrowth was calculated by adding the fracture site shortening from the LLD. Risk factors were assessed in patients with LLD < 1 cm and ≥ 1 cm and overgrowth < 1 cm and ≥ 1 cm.
Results
Casting and titanium elastic nailing (TEN) were performed on 64 and 39 patients, respectively. The mean LLD and overgrowth were 5.6 and 6.4 mm, respectively. There were significant differences in sex (p = 0.018), age (p = 0.041), fibular involvement (p = 0.005), injury mechanism (p = 0.006), and treatment methods (p < 0.001) between patients with LLDs < 1 cm and ≥ 1 cm. There were significant differences in sex (p = 0.029), fibular involvement (p = 0.002), injury mechanism (p = 0.008), and treatment methods (p < 0.001) between patients with overgrowth < 1 cm and ≥ 1 cm. Sex and treatment methods were risk factors associated with LLD ≥ 1 cm and overgrowth ≥ 1 cm following pediatric tibial shaft fracture. The boys had a 7.4-fold higher risk of LLD ≥ 1 cm and 5.4-fold higher risk of overgrowth ≥ 1 cm than the girls. Patients who underwent TEN had a 4.3-fold higher risk of LLD ≥ 1 cm and 4.8-fold higher risk of overgrowth ≥ 1 cm than those treated by casting.
Conclusions
Patients undergoing TEN showed greater LLD and overgrowth than those undergoing casting, with boys showing greater LLD and overgrowth than girls. Surgeons should consider the possibility of LLD and overgrowth after pediatric tibial shaft fractures, especially when performing TEN for boys.
Level of evidence
Level III
Publisher
Springer Science and Business Media LLC
Subject
Orthopedics and Sports Medicine,Surgery
Reference33 articles.
1. Waters PM, Skaggs DL, Flynn JM, Court-Brown CM (2020) Rockwood and Wilkins’ fractures in children, 9th edn. Wolters Kluwer, Philadelphia
2. Naranje SM, Erali RA, Warner WC Jr, Sawyer JR, Kelly DM (2016) Epidemiology of pediatric fractures presenting to emergency departments in the United States. J Pediatr Orthop 36(4):e45–e48
3. Galano GJ, Vitale MA, Kessler MW, Hyman JE, Vitale MG (2005) The most frequent traumatic orthopaedic injuries from a national pediatric inpatient population. J Pediatr Orthop 25(1):39–44
4. Buckley SL, Gotschall C, Robertson W Jr, Sturm P, Tosi L, Thomas M, Eichelberger M (1994) The relationships of skeletal injuries with trauma score, injury severity score, length of hospital stay, hospital charges, and mortality in children admitted to a regional pediatric trauma center. J Pediatr Orthop 14(4):449–453
5. Raducha JE, Swarup I, Schachne JM, Cruz AI Jr, Fabricant PD (2019) Tibial shaft fractures in children and adolescents. JBJS Rev 7(2):e4
Cited by
6 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献