Tibial fractures in children. A retrospective 27-year follow-up study.
BACKGROUND
Tibial fracture is the third most common long-bone fracture in children. Traditionally, most tibial fractures in children have been treated non-operatively, but there are no long-term results.


METHODS
94 children (64 boys) were treated for a tibial fracture in Aurora City Hospital during the period 1980-89 but 20 could not be included in the study. 58 of the remaining 74 patients returned a written questionnaire and 45 attended a follow-up examination at mean 27 (23-32) years after the fracture.


RESULTS
89 children had been treated by manipulation under anesthesia and cast-immobilization, 4 by skeletal traction, and 1 with pin fixation. 41 fractures had been re-manipulated. The mean length of hospital stay was 5 (1-26) days. Primary complications were recorded in 5 children. The childrens' memories of treatment were positive in two-thirds of cases. The mean subjective VAS score (range 0-10) for function appearance was 9. Leg-length discrepancy (5-10 mm) was found clinically in 10 of 45 subjects and rotational deformities exceeding 20° in 4. None of the subjects walked with a limp. None had axial malalignment exceeding 10°. Osteoarthritis of the hip and/or knee was seen in radiographs from 2 subjects.


CONCLUSIONS
The long-term outcome of tibial fractures in children treated non-operatively is generally good.
Children's Hospital , Helsinki University Central Hospital , Helsinki.
Sauli A
SA
Palmu
Sampo
S
Auro
Martina
M
Lohman
Reijo T
RT
Paukku
Jari I
JI
Peltonen
Yrjänä
Y
Nietosvaara
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D005592:Fracture Fixation; D006801:Humans; D007103:Immobilization; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013978:Tibial Fractures / Q000150:complications / Q000601:surgery / Q000628:therapy*; D016896:Treatment Outcome