title: Tibial shaft fractures in adolescents: analysis of cast treatment successes and failures.
abstract: This study retrospectively analyzed cast treatment of 75 adolescent closed tibial diaphyseal fractures. The average age was 13.3 years (range, 10-17.4 years). Of the patients, 21% (16/75) required cast change/wedging in the clinic for loss of reduction, and three patients (4%, 3/75) injured in vehicular collisions had failure of cast treatment, requiring an unplanned surgical intervention. Initial and immediate postreduction radiographic deformities were greater (P<0.05) in patients who required cast change/wedging. Of the patients, 59% (44/75) required over 3 months of cast immobilization. Casting is successful in the majority of adolescent patients despite prolonged immobilization and the need for cast change/wedging.
authors.affiliation: Department of Orthopaedics, Texas Scottish Rite Hospital, Children's Medical Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
authors.forename: Christine A
authors.initials: CA
authors.lastname: Ho
authors.forename: Greg
authors.initials: G
authors.lastname: Dammann
authors.forename: David A
authors.initials: DA
authors.lastname: Podeszwa
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Levy
mesh_terms: D000293:Adolescent; D002370:Casts, Surgical; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D011859:Radiography; D012189:Retrospective Studies; D013165:Splints; D013977:Tibia / Q000000981:diagnostic imaging; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome; D016474:Weight-Bearing / Q000502:physiology