Abstract
Background:
The outcomes of open tibial fractures in a paediatric population are reported.
Methods:
A retrospective analysis of consecutive cases, classified by the Gustilo-Anderson system, over the last 8 years was undertaken. The outcomes recorded were time to union, non-union, infection rates and re-operation rates.
Results:
There were 60 open tibial fractures; 8.3% grade 1, 10.0% grade 2, 38.3% grade 3a, 36.7% grade 3b, and 6.7% grade 3c. There were 19 females and 41 males with a median age of 12 years. The time to first debridement was within 24 hours in 95% of patients. External fixation was used definitively in 62.7% with internal fixation next (13.6%). The mean time to union was 4 months. There was a 10.0% non-union and a 1.7% deep infection rate. Thirty percent needed re-operation: soft tissue procedures (6.7%); malaignment (5%); delayed union (5%) and infection (3.3%). All fractures united at final follow-up. There was no statistical difference between the methods of fixation on non-union rate.
Conclusion:
Open tibial fractures in the paediatric population demonstrate a high union and low deep infection rate as compared to the adults. The findings support the recommendations from current BOA/BAPRAS standards on the management of these injuries.
