Complications of internal fixation in paediatric fractures.
BACKGROUND
Most displaced fractures in children can be managed by closed treatment. Internal fixation of fractures is sometimes required to achieve satisfactory reduction with certain fractures. The aim of this study was to document the rate of complications associated with internal fixation of fractures in the paediatric age group.


METHODS
A retrospective study was carried out on 268 consecutive children who had internal fixation of fractures from January 2000 to July 2004. The complications were categorized as major or minor.


RESULTS
The average age was 9.2 years (range, 1.4-16.9). There were 327 fractures. Fifty-nine children had fractures of two bones. Humeral fractures accounted for 45.7% of fractures, forearm fractures 31.3%, tibial and fibular fractures 14.1% and femoral fractures 4.9%. There were 27 children (10%) with major complications and 49 children (18%) with minor complications. There were 18 children (6.7%) with both major and minor complications. A total of 66 (24.6%) children had complications. There were 23 children (8.5%) requiring further surgery.


CONCLUSIONS
In this study, 24.6% of children had complications associated with internal fixation. The risk of complications should be considered when electing to proceed with surgical treatment. Closed treatment should always be attempted in children unless there is a good indication for internal fixation.
Widjaja
Audi B
AB
Orthopaedic Unit, Monash Medical Centre, Clayton, Victoria, Australia. docaudi@hotmail.com
Eng
Kevin
K
Griffiths
John
J
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005264:Femoral Fractures / Q000601:surgery; D005360:Fibula; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D006810:Humeral Fractures / Q000601:surgery; D007223:Infant; D016268:Internal Fixators / Q000009:adverse effects*; D007866:Leg / Q000033:anatomy & histology; D008297:Male; D010019:Osteomyelitis / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology; D013978:Tibial Fractures / Q000601:surgery; D014739:Victoria