Tibial Shaft Fractures - Pediatric Pathway Posted: 8/8/2020 ID: (C101560)

Open Tibial Shaft Fracture in an 11 Years Male

0%
PRESENTATION
3
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POLLS
12,643
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OUTCOMES
2
0%
EVIDENCE
19
0%
Comments
17
CASE DESCRIPTION
AGE 11 / Male
CC Right leg pain
HPI This is an 11-year-old male presenting as a trauma after being struck by an automobile while crossing the street.
PMH He has no significant past medical history.
PE Significant for a weight of 40kg. There is a 2cm open wound with exposed bone directly over the anterior aspect of the right distal leg, gross deformity, and an otherwise neurovascularly intact extremity with a palpable DP pulse. Compartments are soft.
Pre-procedure IMAGES:
https://upload.orthobullets.com/cases/101560/pre.jpg https://upload.orthobullets.com/cases/101560/pre2.jpg https://upload.orthobullets.com/cases/101560/6c862ac5-8ac8-40b1-b7e0-26230ff54056_img-20200807-wa0003.jpg
POLLS
OB Community
1) In addition to plain film radiographs, would you obtain any further imaging to guide your treatment?
Other
2) Based on the presentation, would you involve Child Protective Services (CPS)?
Other
3) How would you classify this fracture?
Other
4) How would you manage this patient?
Other
5) If you choose Operative management, in addition to irrigation and debridement, what would be your definitive fixation?
Other
6) If you choose Intramedullary nailing (IMN), what type of nail(s) would you use?
Other
7) If you choose Flexible IMN, what technique would you use?
Other
8) If you choose Flexible IMN, what type of nail would you select?
Other
9) If you choose Flexible IMN and attained the construct shown below, would you include supplementary immobilization post-operatively?
Other
10) If you choose Flexible IMN and attained the construct shown below, when would you remove the implants?
Other
CASE OUTCOMES
PROCEDURE 1: Debridement and irrigation, flexible intramedullary nail fixation
Post-procedure P1
https://upload.orthobullets.com/cases/101560/8e00d1a3-5718-450a-ae8c-1cad060c185a_screenshot_20200807-181956__01.jpg https://upload.orthobullets.com/cases/101560/38a1821d-fe80-4691-af8c-51df1f717fe0_screenshot_20200807-182041__01.jpg
EVIDENCE (19)
EXPERT COMMENTS