The distal physes, particularly of the fibula, are areas vulnerable to fracture when subjected to inversion and eversion stresses. In children, both the tibia and fibula consist of a long portion of bone (the diaphysis) with growth plates at either end ( figure 3). The tibial shaft bridges the proximal and distal ends and its anterior surface lies just below the skin. The distal end of the bone forms the superior articular surface of the ankle joint at the tibiotalar articulation and the medial malleolus. The proximal portion of the bone, the tibial plateau, forms the lower surface of the knee joint. ![]() ĬLINICAL ANATOMY - The tibia is the major weightbearing bone of the lower leg ( figure 1 and figure 2). The average age at injury is eight years, and it is more common in boys than girls. Tibial shaft fractures are associated with fibula fractures in 30 percent of cases. Most tibial shaft fractures are short oblique or transverse fractures of the middle or distal third of the shaft. Open fractures, most commonly caused by vehicular related injury, are also a major concern with tibial shaft fractures because the anterior tibia is very close to the skin surface. Thus, special attention should be paid to neurovascular status in the first 24 hours following such injuries. ![]() The high-energy transmitted to the soft tissues surrounding the bone is relevant because of the significant risk for compartment syndrome associated with tibial shaft fractures. ![]() The mechanism varies depending on the age of the patient, with low energy falls and twisting injuries being more common in younger children and high energy motor vehicle accidents and sports-related injuries predominating in older children and adolescents ( image 1). (See "Overview of tibial fractures in children" and "Proximal tibial fractures in children" and "Stress fractures of the tibia and fibula".)ĮPIDEMIOLOGY - Lower leg fractures occur with an incidence of approximately children and are one of the more common lower extremity fractures in children. The general approach to tibial fractures, care of proximal tibial fractures in children, and stress fractures of the tibia and fibula are discussed separately. INTRODUCTION - The evaluation and management of pediatric tibial and fibular shaft fractures will be reviewed here.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |