Tibial shaft fractures are common pediatric injuries, and treatment is individualized based on patient age, concomitant injuries, fracture pattern, and surgeon preference. Fracture healing usually occurs within 10 weeks of injury, and nonunion occurs in less than 2% of patients.7 Closed reduction and casting is the most common mode of treatment for stable pediatric tibial shaft fractures. Typically, a long leg cast is used for 4 to 6 weeks, followed by a short leg cast for another 4 to 6 weeks. Acceptable alignment for closed reduction is up to 5 degrees of varus/valgus angulation, less than 5 degrees of sagittal plane deformity, and up to 1 cm of shortening. Up to 50% translation is acceptable in adolescents and older children.7
- 5 degrees of valgus, 3 degrees of sagittal deformity, and 1 cm of shortening.
7. Mashru RP, Herman MJ, Pizzutillo PD. Tibial shaft fractures in children and adolescents. J Am Acad Orthop Surg 2005;13:345–52.
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