Tibial Shaft Fractures


Tibial shaft fractures are among the most common pediatric injuries and account for 4% to 5% of all pediatric fractures. Tibial shaft fractures may result from low-energy trauma, such as a fall from a standing height (more common in younger children), or high-energy trauma, such as that occurs when a bicyclist is struck by a car. Treatment is individualized based on patient age, concomitant injuries, fracture pattern, and associated soft-tissue and neurovascular injuries. The goal of management of a tibial shaft fracture is complete union with satisfactory alignment in the coronal, sagittal, and axial planes, and acceptable shortening. Most tibial shaft fractures in children can be treated conservatively with closed reduction and casting. Surgical management options include percutaneous pinning with Kirschner wires, external fixation, intramedullary nailing, and plate-and-screw fixation.

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