Percutaneous plating in paediatric tibial fractures.
BACKGROUND
Although non-operative treatment is a mainstay of tibial fracture management in children, certain fractures require a surgical approach. However, choices concerning optimal methods and implants are difficult. The purpose of this study was to determine the effectiveness of percutaneous plating of tibial fractures in children.


METHODS
Sixteen tibial fractures treated using the percutaneous plating technique between 2000 and 2007 were reviewed. The mean age at operation was 10 years 9 months (range: 6-16 years). There were eight open and closed fractures each. Operative indications were acute fractures with associated injuries or fractures, open fractures and compartment syndrome. Nonunions or failures following other treatments were also indicated. Without exposing the fracture sites, the plates were fixed through a subcutaneous tunnel from remote incisions.


RESULTS
All fractures healed without a bone graft. The mean time required for union was 13 weeks (range: 8-24 weeks). No major complications such as malunion, implant failure or deep infection occurred. With the exception of one case with a 15-mm overgrowth, no discrepancy in leg length over 10mm was encountered. Other minor complications included one case each of transient superficial infection and skin irritation caused by the plate. All patients achieved an excellent or satisfactory clinical outcome with no limping.


CONCLUSIONS
Percutaneous plating technique is a safe alternative treatment for paediatric tibial fractures that are difficult to manage using other methods.
Yusof
Nazri Mohd
NM
International Islamic University of Malaysia, Kuantan, Malaysia.
Oh
Chang-Wug
CW
Oh
Jong-Keon
JK
Kim
Joon-Woo
JW
Min
Woo-Kie
WK
Park
Il-Hyung
IH
Kim
Hee-June
HJ
D000293:Adolescent; D001860:Bone Plates; D002648:Child; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D017102:Fracture Healing / Q000502:physiology; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D019919:Prosthesis Implantation / Q000379:methods; D011859:Radiography; D013978:Tibial Fractures / Q000145:classification / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome