A review of open tibia fractures in children

• Published in: Journal of pediatric orthopaedics Vol. 15; no. 4; p. 482
• Main Authors: Kreder, H J, Armstrong, P
• Format: Journal Article
• Language: English
• Published: United States 01.07.1995
• Subjects: Adolescent; Age Factors; Child; Child, Preschool; Female; Fracture Fixation, Internal - adverse effects; Fracture Healing - physiology; Fractures, Open - complications; Fractures, Open - diagnosis; Fractures, Open - mortality; Fractures, Open - therapy; Humans; Incidence; Male; Multiple Trauma - complications; Multiple Trauma - mortality; Multiple Trauma - therapy; Postoperative Complications; Prognosis; Regression Analysis; Retrospective Studies; Risk Factors; Survival Rate; Tibial Fractures - complications; Tibial Fractures - diagnosis; Tibial Fractures - mortality; Tibial Fractures - therapy; Time Factors
• ISSN: 0271-6798
• DOI: 10.1097/01241398-199507000-00015

Fifty-six open tibia fractures in 55 children were studied retrospectively. The overall case fatality rate was 7% (four patients). The most significant factor affecting death rate was injury to the chest and abdomen. Four amputations were performed in four patients with five injuries. Statistically, the presence of neurovascular compromise was significant, with four of eight compromised extremities (in seven patients) requiring amputation. Infection occurred in eight injuries, for an incidence of 14% overall (50% deep). The most important variables were presence of neurovascular injury and delay in getting the patient to surgery. A delay of > 6 h was correlated with a 25% infection rate compared with a 12% rate for those operated on within 6 h. The average time to union was approximately 5 +/- 4 months (range, 1.5-24.8 months). The most significant factor affecting union time was the age of the patient.