Abstract
A 12-year-old female pedestrian struck presented with an isolated injury to the right lower leg. Examination revealed a 1 cm open wound on the medial aspect of the leg directly over the fracture site consistent with a Grade 1 open fracture of the tibial shaft. Imaging confirmed a transverse fracture of the distal tibia and fibula shaft. Further inspection of the X-rays revealed an associated medial malleolus fracture. The open fracture was treated with prompt IV antibiotics and formal irrigation and debridement of the proximal and distal bone fragments. The transverse fracture pattern, distal shaft location, clean non-contaminated open wound, and exposure created to debride the bone factored in the decision to achieve absolute stability with internal compression plating technique. Alternative options for reduction and stabilization of a tibial shaft fracture in a skeletally immature child include casting, external fixation, and flexible intramedullary nails. The ipsilateral non-displaced medial malleolus fracture was managed nonoperatively in a cast. Postoperatively the patient remained non-weight bearing for 6 weeks. Both fractures healed uneventfully in anatomic alignment. The patient returned to unrestricted activity without pain.
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References and Suggested Reading
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Young, M. (2017). Tibial Shaft Fracture: Plating. In: Iobst, C., Frick, S. (eds) Pediatric Orthopedic Trauma Case Atlas. Springer, Cham. https://doi.org/10.1007/978-3-319-28226-8_123-1
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DOI: https://doi.org/10.1007/978-3-319-28226-8_123-1
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Publisher Name: Springer, Cham
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Online ISBN: 978-3-319-28226-8
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