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Treatment and functional outcomes of complex tibial fractures in children and adolescents using the Ilizarov method.

Abstract Aims The aim of this study was to report the clinical, functional and radiological outcomes of children and adolescents with tibial fractures treated using the Ilizarov method. Patients and Methods Between 2013 and 2016 a total of 74 children with 75 tibial fractures underwent treatment at our major trauma centre using an Ilizarov frame. Demographic and clinical information from a prospective database was supplemented by routine functional and psychological assessment and a retrospective review of the notes and radiographs. Results Of the 75 fractures, 26 (35%) were open injuries, of which six (8%) had segmental bone loss. There were associated physeal injuries in 18 (24%), and 12 (16%) involved conversion of treatment following failure of previous management. The remaining children had a closed unstable fracture or significant soft-tissue compromise. The median follow-up was 16 months (7 to 31). All fractures united with a median duration in a frame of 3.6 months (interquartile range 3.1 to 4.6); there was no significant difference between the types of fracture and the demographics of the patients. There were no serious complications and no secondary procedures were required to achieve union. Health-related quality of life measures were available for 60 patients (80%) at a minimum of six months after removal of the frame. These indicated a good return to function (median Paediatric quality of life score, 88.0; interquartile range 70.3 to 100). Conclusion The Ilizarov method is a safe, effective and reliable method for the treatment of complex paediatric tibial fractures. Cite this article: Bone Joint J 2018;100-B:396-403.
PMID
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Authors

Mayor MeshTerms

Ilizarov Technique

Keywords

Circular frame

Complex paediatric tibia fractures

Ilizarov method

Paediatric quality of life measure

Trauma

Journal Title the bone & joint journal
Publication Year Start




PMID- 29589503
OWN - NLM
STAT- MEDLINE
DCOM- 20180402
LR  - 20180402
IS  - 2049-4408 (Electronic)
IS  - 2049-4394 (Linking)
VI  - 100-B
IP  - 3
DP  - 2018 Mar 1
TI  - Treatment and functional outcomes of complex tibial fractures in children and
      adolescents using the Ilizarov method.
PG  - 396-403
LID - 10.1302/0301-620X.100B3.BJJ-2017-0863.R1 [doi]
AB  - Aims The aim of this study was to report the clinical, functional and
      radiological outcomes of children and adolescents with tibial fractures treated
      using the Ilizarov method. Patients and Methods Between 2013 and 2016 a total of 
      74 children with 75 tibial fractures underwent treatment at our major trauma
      centre using an Ilizarov frame. Demographic and clinical information from a
      prospective database was supplemented by routine functional and psychological
      assessment and a retrospective review of the notes and radiographs. Results Of
      the 75 fractures, 26 (35%) were open injuries, of which six (8%) had segmental
      bone loss. There were associated physeal injuries in 18 (24%), and 12 (16%)
      involved conversion of treatment following failure of previous management. The
      remaining children had a closed unstable fracture or significant soft-tissue
      compromise. The median follow-up was 16 months (7 to 31). All fractures united
      with a median duration in a frame of 3.6 months (interquartile range 3.1 to 4.6);
      there was no significant difference between the types of fracture and the
      demographics of the patients. There were no serious complications and no
      secondary procedures were required to achieve union. Health-related quality of
      life measures were available for 60 patients (80%) at a minimum of six months
      after removal of the frame. These indicated a good return to function (median
      Paediatric quality of life score, 88.0; interquartile range 70.3 to 100).
      Conclusion The Ilizarov method is a safe, effective and reliable method for the
      treatment of complex paediatric tibial fractures. Cite this article: Bone Joint J
      2018;100-B:396-403.
FAU - Messner, J
AU  - Messner J
AD  - Leeds Major Trauma Centre and Limb Reconstruction Unit, Leeds Children's Hospital
      at Leeds General Infirmary, Great George Street, Leeds LS1 3EX, UK.
FAU - Johnson, L
AU  - Johnson L
AD  - Leeds Major Trauma Centre and Limb Reconstruction Unit, Leeds Children's Hospital
      at Leeds General Infirmary, Great George Street, Leeds LS1 3EX, UK.
FAU - Taylor, D M
AU  - Taylor DM
AD  - Leeds Major Trauma Centre and Limb Reconstruction Unit, Leeds Children's Hospital
      at Leeds General Infirmary, Great George Street, Leeds LS1 3EX, UK.
FAU - Harwood, P
AU  - Harwood P
AD  - Leeds Major Trauma Centre and Limb Reconstruction Unit, Leeds Children's Hospital
      at Leeds General Infirmary, Great George Street, Leeds LS1 3EX, UK.
FAU - Britten, S
AU  - Britten S
AD  - Leeds Major Trauma Centre and Limb Reconstruction Unit, Leeds Children's Hospital
      at Leeds General Infirmary, Great George Street, Leeds LS1 3EX, UK.
FAU - Foster, P
AU  - Foster P
AD  - Leeds Major Trauma Centre and Limb Reconstruction Unit, Leeds Children's Hospital
      at Leeds General Infirmary, Great George Street, Leeds LS1 3EX, UK.
LA  - eng
PT  - Journal Article
PL  - England
TA  - Bone Joint J
JT  - The bone & joint journal
JID - 101599229
SB  - AIM
SB  - IM
MH  - Adolescent
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - Humans
MH  - *Ilizarov Technique
MH  - Male
MH  - Prospective Studies
MH  - Quality of Life
MH  - Retrospective Studies
MH  - Tibial Fractures/*surgery
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Circular frame
OT  - Complex paediatric tibia fractures
OT  - Ilizarov method
OT  - Paediatric quality of life measure
OT  - Trauma
EDAT- 2018/03/29 06:00
MHDA- 2018/04/03 06:00
CRDT- 2018/03/29 06:00
PHST- 2018/03/29 06:00 [entrez]
PHST- 2018/03/29 06:00 [pubmed]
PHST- 2018/04/03 06:00 [medline]
AID - 10.1302/0301-620X.100B3.BJJ-2017-0863.R1 [doi]
PST - ppublish
SO  - Bone Joint J. 2018 Mar 1;100-B(3):396-403. doi:
      10.1302/0301-620X.100B3.BJJ-2017-0863.R1.