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. 2005 Dec;29(6):392-5.
doi: 10.1007/s00264-005-0009-3. Epub 2005 Aug 10.

Casting versus surgical fixation for grade IIIA open tibial diaphysial fractures in children: effect on the rate of infection and the need for secondary surgical procedures to promote bone union

C P Charalambous  1 , F Alvi, I Siddique, M Zenios, P Hirst, P Marshall
Affiliations

Casting versus surgical fixation for grade IIIA open tibial diaphysial fractures in children: effect on the rate of infection and the need for secondary surgical procedures to promote bone union

C P Charalambous et al. Int Orthop. 2005 Dec.

Abstract
in English, French

We evaluated 39 grade IIIA open tibial fractures presenting in children younger than 13 years of age, to determine if the mode of fracture stabilization (casting vs. surgical fixation) was related to the rate of infection or the need for secondary surgical procedures to promote bone union. All fractures had wound debridement in the operating room. Thirty patients had manipulation and casting, and nine surgical internal or external fixation. There were two cases of infection in the cast-treated group and two in the surgical fixation group (P=0.17). None of the fractures required a secondary surgical procedure to promote bone union. Three of the fractures treated by manipulation and casting displaced; two required re-manipulation and casting and one was converted to external fixation. In two cases the applied external fixator had to be re-aligned. Our results suggest that manipulation and casting is a reliable treatment for open tibial fractures in children.

Nous avons évalué 39 fractures tibiales ouvertes niveau IIIA survenues chez des enfants de moins de 13 ans, pour déterminer si le mode de stabilisation de la fracture (plâtre contre fixation chirurgicale) a été en rapport avec le taux d'infection ou la nécessité d'interventions chirurgicales secondaires pour obtenir la consolidation. Toutes les fractures avaient un parage en salle d'opération. Trente malades avaient une réduction suivie d'un plâtre, et neuf une fixation chirurgicale interne ou externe. Il y avait deux cas d'infection dans le groupe traité par plâtre et deux dans le groupe fixation chirurgicale (P=0,17). Aucun des fractures n'a nécessité une intervention chirurgicale. Trois fractures traitées par plâtre se sont déplacées, avec nouvelle réduction et plâtre pour deux, et utilisation d'un fixateur externe pour la troisième. Dans deux cas les fixateurs externes ont du être réalignés. Nos résultats suggèrent que le traitement orthopédique par réduction et plâtre est un traitement fiable pour les fractures tibiales ouvertes chez les enfants.

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