A Retrospective Comparison of Above- vs Below-the-Knee Cast Treatment for Salter Harris-II Distal Tibia Fractures. Foot Ankle Orthop 2022 Jan;7(1):24730114211069063
Date
02/01/2022Pubmed ID
35097491Pubmed Central ID
PMC8793615DOI
10.1177/24730114211069063Scopus ID
2-s2.0-85123479813 (requires institutional sign-in at Scopus site) 1 CitationAbstract
BACKGROUND: Distal tibia fractures are common in the pediatric patient population. Recent reports suggest that patients with closed low-energy distal tibial fractures treated with short leg casts (SLCs) have similar radiographic outcomes with improved functional outcomes compared to those treated with long leg casts (LLCs). However, to date there has not been a study comparing these treatment modalities for Salter-Harris (SH) II distal tibia fractures. The purpose of this study was to compare the radiographic and time to weightbearing outcomes between patients with SH-II tibial ankle fractures treated with an SLC vs an LLC.
METHODS: A retrospective review on SH-II distal tibia fractures was performed at a Level I pediatric trauma center from 2013 to 2020. Primary outcomes included final coronal angulation, sagittal angulation, and time to weightbearing.
RESULTS: A total of 59 patients with SH-II distal tibia fractures were treated with an SLC (22 patients, median age 11.79 years) or an LLC (37 patients, median age 12.17 years). There was no statistically significant difference between the 2 treatment groups for coronal angulation at final follow-up, sagittal angulation at final follow-up, or percentage of patients fully weightbearing at 6 weeks (P > .05). No patients required subsequent remanipulation or operative treatment in either treatment group.
CONCLUSION: In this retrospective review with relatively short-term follow-up, SLCs were found to be noninferior to LLCs for treatment of reduced SH-II distal tibia fractures. This casting option may still be considered by surgeons who are nonoperatively managing pediatric distal tibia fractures.
LEVEL OF EVIDENCE: Level III, retrospective comparative study.
Author List
Dasari SP, Kukushliev VV, Graf AR, Liu XC, Van Valin SEAuthors
Alexander Reed Graf MD Assistant Professor in the Orthopaedic Surgery department at Medical College of WisconsinXue-Cheng Liu PhD Professor in the Orthopaedic Surgery department at Medical College of Wisconsin
Scott Van Valin MD Associate Professor in the Orthopaedic Surgery department at Medical College of Wisconsin
