Journal of pediatric orthopedics
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Fractures of the tibia are common in children. Fractures of the distal tibial metaphysis have been only described in fracture texts without reference to a peer-reviewed study. The purpose of the present study was to review this fracture pattern and report the results of treatment. ⋯ The patterns of displacement of the distal tibial metaphyseal fractures reported in our study vary from those presented in textbooks. Distal tibial metaphyseal fractures can present with 2 types of displacement: valgus recurvatum and varus procurvatum. Fractures of the fibula always present with the same pattern as the tibia. Primary union of the distal tibial metaphyseal fracture may be expected in all cases regardless of the type of fracture, age, and gender.
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The Taylor Spatial Frame (TSF) is a modern multiplanar external fixator that combines ease of application plus computer accuracy in the reduction of fractures. A retrospective review of our experience in using this device for treating unstable tibia fractures in pediatric and adolescent patients was carried out to determine the effectiveness and complications of TSF in the treatment of these fractures. Ten tibia fractures were included. ⋯ All patients were doing well and involved in sports when last seen. Postoperative complications included pin tract infection in 5 patients. TSF is an effective definitive method of tibia fracture care with the advantage of early mobilization and ability to postoperatively manipulate fracture into excellent alignment.
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Appropriate care of pediatric polytrauma patients requires the knowledge and expertise of a variety of subspecialists. Though most of pediatric polytrauma patients survive, long-term sequelae are common. The most common causes of long-term functional deficits after pediatric polytrauma involve injuries to the central nervous and musculoskeletal systems. Orthopaedic care of polytrauma patients is important to facilitate early mobilization and care of these children, as well as to minimize late impairment.