Tibial Shaft Fracture: Cast Treatment
A 14-year-old boy sustained a closed right tibial shaft fracture when tackled while kicking a field goal during a football game. The fracture was oblique and comminuted in the setting of open physes. He was treated with closed manipulation and long leg casting. The cast was wedged in the operating room to improve alignment. At 4 weeks postoperatively he was transitioned to a patellar tendon bearing fracture brace with touchdown weight bearing and physical therapy for gentle ankle and knee motion. Weight bearing was then progressed as the fracture continued to heal and the patellar tendon bearing fracture brace was cut down to a below-knee fracture brace. At 3 months postoperatively he was allowed to weight bear as tolerated without the fracture brace, and he was cleared to return to full activities 4 months postoperatively.
References and Suggested Reading
- AO Trauma Foundation (2016) AO surgery reference. https://aotrauma.aofoundation.org/Structure/education/self-directed-learning/reference-materials/ao-surgery-reference/Pages/ao-surgery-reference.aspx. Accessed 15 Jan 2017
- Heinrich SD, Mooney JF (2010) Fractures of the shaft of the tibia and fibula. In: Beaty JH, Kasser JR (eds) Rockwood and Wilkins’ fractures in children, 7thedn edn. Lippincott Williams & Wilkins, PhiladelphiaGoogle Scholar