OTA 2002 - Session 9 Session IX - Pediatrics Sun., 10/13/02 Pediatrics/Spine, Paper #57, 8:44 AM Bridge Plating of Pediatric Femur Fractures Enes M. Kanlic, MD, PhD 1 ; Douglas G. Smith, MD 2 ; Jeffrey O. Anglen, MD 3 ; Steven B. Morgan, MD 4 ; Rodrigo R. Pesantez, MD 5 ; 1 Texas Tech University, El Paso, Texas, USA; 2 Harborview Medical Center, University of Washington, Seattle, Washington, USA; 3 University of Missouri Hospitals and Clinics, Columbia, Missouri, USA; 4 Denver Health Medical Center, Denver, Colorado, USA; 5 Fundación Santa Fe' de Bogota, Bogota, Columbia

Pediatric tibia fractures: current concepts. Current Opinion in Pediatrics. 18(1):30-35, February 2006. Setter, Kevin J. a; Palomino, Kathryn E. b Abstract: Purpose of review: Fracture of the tibia is a common occurrence in children. The operative treatment of pediatric tibia fractures has undergone a recent change. However, there is no clear consensus regarding the superiority of one treatment option. Recent findings: The literature clearly supports the fact that the vast majority of pediatric tibia fractures can and should be managed nonoperatively. This is secondary to their inherent stability. A variety of factors including fracture type, location, severity and patient age determine the best treatment options for a particular fracture. A thorough understanding of these factors and how they affect outcome, help the clinician formulate the proper plan of treatment. Summary: A randomized prospective controlled trial will be necessary to establish which surgical options are superior for which type of pediatric tibia fracture. Until then, recent studies have indicated that flexible intramedullary nails may lead to a shorter time to union and a decreased rate of refracture when compared with external fixation of unstable tibial shaft fractures. What remains unclear are the specific indications and contraindication for the use of flexible nails. External fixation still remains a successful treatment option for unstable tibial shaft fractures.

OTA 2002 - Session 9 Session IX - Pediatrics Sun., 10/13/02 Pediatrics/Spine, Paper #58, 8:50 AM External Fixation of Pediatric Femur Fractures. Should We Abandon this Technique? R. Dale Blasier, MD; Rosalind R. White, RN; Arkansas Children's Hospital, Little Rock, Arkansas, USA

OTA 2002 - Session 5 Session V - Foot and Ankle Sat., 10/12/02 Foot & Ankle, Paper #36, 10:00 AM Os Calcis Fractures in Children and Adolescents: Long Term Results of Operative Treatment Nirmal C. Tejwani, MD , New York, New York, USA; Roderick Kuo, MD, Sydney, Australia; Christopher DiGiovanni, MD, Providence, Rhode Island; Sarah K. Holt, MSPH; Stephen K. Benirschke, MD; Bruce J. Sangeorzan, MD; Harborview Medical Center, University of Washington, Seattle, Washington, USA Purpose : We reviewed the results of calcaneal fractures in children and adolescents. Method : We studied a series of 47 calcaneus fractures in 40 children and adolescents less than 18 years of age treated at our institution from 1988 to 1998. Open reduction and internal fixation was performed by the two senior authors on 34 of the intraarticular fractures. Similar to adults, the most common mechanism causing the injury was a fall or jump from a height. Most of the fractures were intraarticular (78%) and joint depression type. Associated injuries were found in all the patients treated nonoperatively and in 11 of the operated group. We reviewed the results of all patients (average follow-up 5.2 years; range, 2 to 12 years) and calculated the AOFAS score for outcome. Results: Our overall results were excellent (AOFAS score 80 to 100); most (95%) of our patients had regained excellent range and function by the last follow-up. Four of the operated group had complications in the form of claw toeing, and, of these, only two needed additional surgery. One patient also needed a corrective osteotomy because of valgus growth deformity of the calcaneus. Of the 12 patients whose calcanei were not fixed, 5 had an amputation due to the severity of their injuries, and 3 had skin grafting or a flap for soft tissue injury. The remaining patients were treated in a short leg cast for 4 weeks. Conclusions : Operative treatment for displaced and comminuted intraarticular fractures with joint incongruity produces excellent results in children and adolescents. There was no major difference in the fracture pattern, mechanism of injury, clinical presentation, management and prognosis between children and adults in this fracture group.

Abstracts of articles on Calcaneal Fractures, Cuboid Fractures, Carpal #s, Toddlers fractures, Metatarsal fractures and others.