Pediatric Tibial Shaft Fractures Remodeling After Casting

Background and The tibial shaft fracture is the most common long bone fracture in children. This type of fracture has a high capacity for deformity correction, a process known as remodeling. In many circumstances, casting is the choice of treatment.

This study aims to investigate the rate of tibial fracture remodeling after 6 months of non-rigid fixation.

This research was a retrospective study conducted from March 2017 to March 2018. The study population included 74 children with tibial shaft fracture, treated with a long leg plaster under general anesthesia. Patients were evaluated by obtaining anteroposterior (AP) and lateral view x-rays in the first week, second week, 2 months, and 6 months after casting.

Seventy-four individuals were admitted with a diagnosis of tibial shaft fracture. A total number of 39 patients (52%)-13 girls and 26 boys- were treated with the long-leg casting under general anesthesia. The patients’ average age was 7.94±2.69 years (2-14 years). In the second week, four cases were excluded. Remodeling in the fracture site was significant in AP radiography at the end of the second month (P=0.044). Six-month follow-up showed that the remodeling in AP was significant (P=0.017) while in lateral was partially significant (P=0.05).

Due to the presence of the growth plate and a dense periosteum, remodeling of the tibial shaft fracture is extremely likely, and the remaining deformity is corrected over time by casting, and no surgical intervention is required. Level of evidence: IV