Tiến sĩ mashru IS viên Chấn thương, Bệnh viện Campbell, Đại học Tennessee College of Medicine, Memphis, TN. Tiến sĩ Herman IS Trợ lý Giáo sư, Nhi khoa và chỉnh hình, Trung tâm chỉnh hình cho trẻ em, St Christopher của Bệnh viện Nhi, Philadelphia, PA. Tiến sĩ IS Pizzutillo trưởng, chỉnh hình Phẫu thuật Mục, | Tibial Shaft Fractures in Children and Adolescents Rakesh P. Mashru MD Martin J. Herman MD and Peter D. Pizzutillo MD Dr. Mashru is Trauma Fellow Campbell Clinic University of Tennessee College of Medicine Memphis TN. Dr. Herman is Assistant Professor Orthopedics and Pediatrics Orthopedic Center for Children St. Christopher s Hospital for Children Philadelphia PA. Dr. Pizzutillo is Chief Orthopedic Surgery Section Director Orthopedic Center for Children and Professor Pediatrics and Orthopedic Surgery St. Christopher s Hospital for Children Philadelphia. None of the following authors or the departments with which they are affiliated has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article Dr. Mashru Dr. Herman and Dr. Pizzutillo. Reprint requests Dr. Herman Orthopedic Center for Children St. Christopher s Hospital for Children Erie Avenue at Front Street Philadelphia PA 19134. J Am Acad Orthop Surg 2005 13 345-352 Copyright 2005 by the American Academy of Orthopaedic Surgeons. Abstract Tibial shaft fractures are among the most common pediatric injuries managed by orthopaedic surgeons. Treatment is individualized based on patient age concomitant injuries fracture pattern associated soft-tissue and neurovascular injury and surgeon experience. Closed reduction and casting is the mainstay of treatment for diaphyseal tibial fractures. Careful clinical and radiographic follow-up with remanipulation as necessary is effective for most patients. Surgical management options include external fixation locked intramedullary nail fixation in the older adolescent with closed physis Kirschner wire fixation and flexible intramedullary nailing. Union of pediatric diaphyseal tibial fractures occurs in approximately 10 weeks nonunion occurs in 2 of cases. Some clinicians consider sagittal deformity angulation 10 to be malunion and indicate that 10 of valgus and 5 of varus may not reliably .
