Trauma: Complications of Tibial and Ankle Region Fractures

ortopedi-16-2-2024-kapak-1

Sema ERTANa , Ahmet Yiğit KAPTANb

aİstanbul Başakşehir Çam ve Sakura City Hospital, Clinic of Orthopedics and Traumatology, İstanbul, Türkiye
bHarran University Faculty of Medicine, Department of Orthopedics and Traumatology, Şanlıurfa, Türkiye

ABSTRACT
Fractures of the tibia and ankle region are common fractures in children. The majority of fractures in this region heal without the need for surgical treatment. Complications that may be encountered after trauma vary according to the severity of the trauma, the age and gender of the child, and the type of fracture. Compartment syndrome is the most important complication that can be seen in the early period and should be intervened in a timely manner. In the late period, delayed union, non-union, malunion and premature physeal closure are the most common and important complications. These complications may occur as a result of surgery or conservative treatments. The most important step in the prevention of complications that may be encountered in the late period is compliance with the principles of treatment and regular follow-up. Informing families about deformities that may occur in the long term will increase compliance with treatment.
Keywords: Tibial fractures; ankle fractures; compartment syndromes; fracture healing

Referanslar

  1. Hogue GD, Wilkins KE, Kim IS. Management of Pediatric Tibial Shaft Fractures. J Am Acad Orthop Surg. 2019;27(20):769-78. [Crossref]  [PubMed]
  2. Setter KJ, Palomino KE. Pediatric tibia fractures: current concepts. Curr Opin Pediatr. 2006;18(1):30-5. [Crossref]
  3. Mashru RP, Herman MJ, Pizzutillo PD. Tibial shaft fractures in children and adolescents. J Am Acad Orthop Surg. 2005;13(5):345-52. [Crossref]  [PubMed]
  4. Wang H, Liu H, Wu J, Li C, Zhou Y, Liu J, et al. Age, gender, and etiology differences of sports-related fractures in children and adolescents: A retrospective observational study. Medicine (Baltimore). 2019;98(4):e13961. [Crossref]  [PubMed]  [PMC]
  5. Stenroos A, Puhakka J, Nietosvaara Y, Kosola J. Treatment of Closed Tibia Shaft Fractures in Children: A Systematic Review and Meta-Analysis. Eur J Pediatr Surg. 2020;30(6):483-9. [Crossref]  [PubMed]
  6. Shore BJ, Glotzbecker MP, Zurakowski D, Gelbard E, Hedequist DJ, Matheney TH. Acute compartment syndrome in children and teenagers with tibial shaft fractures: incidence and multivariable risk factors. J Orthop Trauma. 2013;27(11):616-21. [Crossref]  [PubMed]
  7. McQueen MM, Christie J, Court-Brown CM. Acute compartment syndrome in tibial diaphyseal fractures. J Bone Joint Surg Br. 1996;78(1):95-8. [Crossref]  [PubMed]
  8. Park S, Ahn J, Gee AO, Kuntz AF, Esterhai JL. Compartment syndrome in tibial fractures. J Orthop Trauma. 2009;23(7):514-8. [Crossref]  [PubMed]
  9. Flynn JM, Bashyal RK, Yeger-McKeever M, Garner MR, Launay F, Sponseller PD. Acute traumatic compartment syndrome of the leg in children: diagnosis and outcome. J Bone Joint Surg Am. 2011;93(10):937-41. [Crossref]  [PubMed]
  10. Bae DS, Kadiyala RK, Waters PM. Acute compartment syndrome in children: contemporary diagnosis, treatment, and outcome. J Pediatr Orthop. 2001;21(5):680-8. [Crossref]  [PubMed]
  11. Obey MR, Shlykov MA, Nickel KB, Keller M, Hosseinzadeh P. Incidence and risk factors for acute compartment syndrome in pediatric tibia fractures. J Pediatr Orthop B. 2023;32(4):401-4. [Crossref]  [PubMed]  [PMC]
  12. Khan H, Monsell F, Duffy S, Trompeter A, Bridgens A, Gelfer Y. Paediatric tibial shaft fractures: an instructional review for the FRCS exam. Eur J Orthop Surg Traumatol. 2023;33(6):2663-6. [Crossref]  [PubMed]
  13. Arslan H, Subaşý M, Kesemenli C, Ersuz H. Occurrence and treatment of nonunion in long bone fractures in children. Arch Orthop Trauma Surg. 2002;122(9-10):494-8. Erratum in: Arch Orthop Trauma Surg. 2003;123(2-3):137. [Crossref]  [PubMed]
  14. von Rüden C, Dietz SO, Schmittenbecher P, Fernandez FF, Lieber J, Wilkens B, et al. Pediatric aseptic lower leg fracture nonunion. Eur J Trauma Emerg Surg. 2021;47(2):303-11. [Crossref]  [PubMed]  [PMC]
  15. Zura R, Braid-Forbes MJ, Jeray K, Mehta S, Einhorn TA, Watson JT, et al. Bone fracture nonunion rate decreases with increasing age: A prospective inception cohort study. Bone. 2017;95:26-32. [Crossref]  [PubMed]
  16. Andreacchio A, Alberghina F, Marengo L, Canavese F. Pediatric tibia and femur fractures in patients weighing more than 50 kg (110 lb): mini-review on current treatment options and outcome. Musculoskelet Surg. 2019;103(1):23-30. [Crossref]  [PubMed]
  17. Heath D, Momtaz D, Ghali A, Salazar L, Gibbons S, Hogue G. Obesity Increases Time to Union in Surgically Treated Pediatric Fracture Patients. J Am Acad Orthop Surg Glob Res Rev. 2022;6(1):e21.00185. [Crossref]  [PubMed]  [PMC]
  18. Liow RY, Montgomery RJ. Treatment of established and anticipated nonunion of the tibia in childhood. J Pediatr Orthop. 2002;22(6):754-60. [Crossref]
  19. Harley BJ, Beaupre LA, Jones CA, Dulai SK, Weber DW. The effect of time to definitive treatment on the rate of nonunion and infection in open fractures. J Orthop Trauma. 2002;16(7):484-90. [Crossref]  [PubMed]
  20. Iobst CA, Tidwell MA, King WF. Nonoperative management of pediatric type I open fractures. J Pediatr Orthop. 2005;25(4):513-7. [Crossref]  [PubMed]
  21. Shannak AO. Tibial fractures in children: follow-up study. J Pediatr Orthop. 1988;8(3):306-10. [Crossref]  [PubMed]
  22. Yang JP, Letts RM. Isolated fractures of the tibia with intact fibula in children: a review of 95 patients. J Pediatr Orthop. 1997;17(3):347-51. [Crossref]
  23. Yang CC, Tu PY, Shen PC, Chou SH, Tien YC, Tseng HJ. Prevalence of Cozen's Phenomenon of the Proximal Tibia. J Pediatr Orthop. 2022;42(1):e100. [Crossref]  [PubMed]
  24. Murphy D, Raza M, Monsell F, Gelfer Y. Modern management of paediatric tibial shaft fractures: an evidence-based update. Eur J Orthop Surg Traumatol. 2021;31(5):901-9. [Crossref]  [PubMed]
  25. Bible JE, Smith BG. Ankle fractures in children and adolescents. Techniques in Orthopaedics. 2009;24(3):211-9. [Crossref]
  26. Su AW, Larson AN. Pediatric Ankle Fractures: Concepts and Treatment Principles. Foot Ankle Clin. 2015;20(4):705-19. [Crossref]  [PubMed]  [PMC]
  27. Venkatadass K, Sangeet G, Prasad VD, Rajasekaran S. Paediatric Ankle Fractures: Guidelines to Management. Indian J Orthop. 2020;55(1):35-46. [Crossref]  [PubMed]  [PMC]
  28. Herring JA. Tachdjian's Pediatric Orthopaedics: From the Texas Scottish Rite Hospital for Children. 6th ed. Philadelphia: 2022. p.1378-99.
  29. Wattenbarger JM, Gruber HE, Phieffer LS. Physeal fractures, part I: histologic features of bone, cartilage, and bar formation in a small animal model. J Pediatr Orthop. 2002;22(6):703-9. [Crossref]  [PubMed]
  30. Cass JR, Peterson HA. Salter-Harris Type-IV injuries of the distal tibial epiphyseal growth plate, with emphasis on those involving the medial malleolus. J Bone Joint Surg Am. 1983;65(8):1059-70. [Crossref]
  31. Barmada A, Gaynor T, Mubarak SJ. Premature physeal closure following distal tibia physeal fractures: a new radiographic predictor. J Pediatr Orthop. 2003;23(6):733-9. [Crossref]  [PubMed]
  32. Spiegel PG, Cooperman DR, Laros GS. Epiphyseal fractures of the distal ends of the tibia and fibula. A retrospective study of two hundred and thirty-seven cases in children. J Bone Joint Surg Am. 1978;60(8):1046-50. [Crossref]  [PubMed]
  33. de Sanctis N, Della Corte S, Pempinello C. Distal tibial and fibular epiphyseal fractures in children: prognostic criteria and long-term results in 158 patients. J Pediatr Orthop B. 2000;9(1):40-4. [Crossref]  [PubMed]
  34. Seel EH, Noble S, Clarke NM, Uglow MG. Outcome of distal tibial physeal injuries. J Pediatr Orthop B. 2011;20(4):242-8. [Crossref]  [PubMed]
  35. Cai H, Wang Z, Cai H. Surgical indications for distal tibial epiphyseal fractures in children. Orthopedics. 2015;38(3):e189-95. [Crossref]  [PubMed]
  36. Rohmiller MT, Gaynor TP, Pawelek J, Mubarak SJ. Salter-Harris I and II fractures of the distal tibia: does mechanism of injury relate to premature physeal closure? J Pediatr Orthop. 2006;26(3):322-8. [Crossref]  [PubMed]
  37. Podeszwa DA, Mubarak SJ. Physeal fractures of the distal tibia and fibula (Salter-Harris Type I, II, III, and IV fractures). J Pediatr Orthop. 2012;32 Suppl 1:S62-8. [Crossref]  [PubMed]
  38. Berson L, Davidson RS, Dormans JP, Drummond DS, Gregg JR. Growth disturbances after distal tibial physeal fractures. Foot Ankle Int. 2000;21(1):54-8. [Crossref]  [PubMed]
  39. Jalkanen J, Sinikumpu JJ, Puhakka J, Laaksonen T, Nietosvaara Y, Kosola J, et al. Physeal Fractures of Distal Tibia: A Systematic Review and Meta-analysis. J Pediatr Orthop. 2021;41(7):e506-e11. [Crossref]  [PubMed]
  40. Nenopoulos SP, Papavasiliou VA, Papavasiliou AV. Outcome of physeal and epiphyseal injuries of the distal tibia with intra-articular involvement. J Pediatr Orthop. 2005;25(4):518-22. [Crossref]  [PubMed]
  41. Hynes D, O'Brien T. Growth disturbance lines after injury of the distal tibial physis. Their significance in prognosis. J Bone Joint Surg Br. 1988;70(2):231-3. [Crossref]  [PubMed]
  42. Khoshhal KI, Kiefer GN. Physeal bridge resection. J Am Acad Orthop Surg. 2005;13(1):47-58. [Crossref]  [PubMed]
  43. Olgun ZD, Maestre S. Management of Pediatric Ankle Fractures. Curr Rev Musculoskelet Med. 2018;11(3):475-484. [Crossref]  [PubMed]  [PMC]
  44. Phan VC, Wroten E, Yngve DA. Foot progression angle after distal tibial physeal fractures. J Pediatr Orthop. 2002;22(1):31-5. [Crossref]  [PubMed]
  45. Cooperman DR, Spiegel PG, Laros GS. Tibial fractures involving the ankle in children. The so-called triplane epiphyseal fracture. J Bone Joint Surg Am. 1978;60(8):1040-6. [Crossref]  [PubMed]
  46. Mubarak SJ. Extensor retinaculum syndrome of the ankle after injury to the distal tibial physis. J Bone Joint Surg Br. 2002;84(1):11-4. [Crossref]  [PubMed]
  47. Goldschneider KR. Complex regional pain syndrome in children: asking the right questions. Pain Res Manag. 2012;17(6):386-90. [Crossref]  [PubMed]  [PMC]
  48. Lascombes P, Mamie C. Complex regional pain syndrome type I in children: What is new? Orthop Traumatol Surg Res. 2017;103(1S):S135-S42. [Crossref]  [PubMed]
  49. Wilder RT. Management of pediatric patients with complex regional pain syndrome. Clin J Pain. 2006;22(5):443-8. [Crossref]  [PubMed]
  50. Dietz FR, Compton SP. Outcomes of a Simple Treatment for Complex Regional Pain Syndrome Type I in Children. Iowa Orthop J. 2015;35:175-80.
  51. Frick SL, Shoemaker S, Mubarak SJ. Altered fibular growth patterns after tibiofibular synostosis in children. J Bone Joint Surg Am. 2001;83(2):247-54. [Crossref]  [PubMed]
  52. Jung ST, Wang SI, Moon YJ, Mubarak SJ, Kim JR. Posttraumatic Tibiofibular Synostosis After Treatment of Distal Tibiofibular Fractures in Children. J Pediatr Orthop. 2017;37(8):532-36. [Crossref]  [PubMed]
  53. Caterini R, Farsetti P, Ippolito E. Long-term followup of physeal injury to the ankle. Foot Ankle. 1991;11(6):372-83. [Crossref]  [PubMed]
  54. Ertl JP, Barrack RL, Alexander AH, VanBuecken K. Triplane fracture of the distal tibial epiphysis. Long-term follow-up. J Bone Joint Surg Am. 1988;70(7):967-76. [Crossref]  [PubMed]
  55. Tarr RR, Resnick CT, Wagner KS, Sarmiento A. Changes in tibiotalar joint contact areas following experimentally induced tibial angular deformities. Clin Orthop Relat Res. 1985;(199):72-80. [Crossref]