title: Tibia Shaft Fractures in Adolescents: How and When Can They be Managed Successfully With Cast Treatment?
abstract: Despite the increasing popularity of operative treatment in adolescent tibia fractures, casting remains a viable first-line treatment. Because the selection bias in published reports does not allow direct comparison between casting and flexible nail treatment of closed pediatric tibia fractures, it is unclear whether flexible nailing offers any advantages over casting. This overview discusses parameters of acceptable alignment, indications, techniques for successful reduction and casting, subsequent inpatient and outpatient management including wedging of casted tibia fractures, expected outcomes, and comparison of casting with flexible nailing. As with any orthopaedic procedure, careful attention to patient selection, indications, and detail facilitates successful cast treatment in this older pediatric population.
authors.affiliation: *Texas Scottish Rite Hospital for Children-Children's Health Dallas †Department of Orthopaedics, University of Texas Southwestern Medical School, Dallas, TX.
authors.forename: Christine A
authors.initials: CA
authors.lastname: Ho
mesh_terms: D000293:Adolescent; D002370:Casts, Surgical / Q000009:adverse effects*; D002648:Child; D019468:Disease Management; D005594:Fracture Fixation, Intramedullary / Q000009:adverse effects / Q000379:methods; D006801:Humans; D008349:Manipulation, Orthopedic / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D018579:Patient Selection; D010372:Pediatrics / Q000379:methods; D013977:Tibia / Q000000981:diagnostic imaging / Q000601:surgery; D013978:Tibial Fractures / Q000175:diagnosis / Q000601:surgery / Q000628:therapy; D016896:Treatment Outcome