Outcomes of Conservative versus Operative Management in Fracture Shaft Tibia and Fracture Shaft Femur in Pediatric Age Group

Abstract

Background: Tibia is more often involved in open fractures because of its subcutaneous location. Severe open fractures of tibia are associated with high complication rate and poor long term outcomes. 70% of pediatric tibial fractures are isolated injuries and approximately 30% of pediatric shaft tibia fractures are associated with fibula fracture. AIM: The aim is to study clinical and radiological outcomes of patient with tibial and femoral fractures, who are treated with closed reduction and internal fixation with nailing versus treated conservatively by casting. Material and method: 40 cases with femur or tibia fractures treated with nailing and conservatively between 1st January 2022 to 30thNovember 2022 at rural medical college, loni a rural tertiary care hospital was analyzed retrospectively out of which 16 patients treated conservatively and 4 patients underwent operative management for tibia fractures while 16 patients were treated operatively and 4 patients treated conservatively for femur fractures. Results: Total 40 patients of shaft femur and shaft tibia fractures were treated conservatively with cast application and Closed reduction and internal fixation by elastic nailing. In comparision for simple transverse fracture, we can conclude that in most patients fracture can be treated conservatively to minimize soft tissue damage but only in unacceptable criteria for conservative management we can opt for minimally invasive procedure like TENS nailing. Conclusion: Immobilization time is shorter in surgical group but we have started mobilizing with cast application. It is the only advantage of surgical management which has been given in conservatively managed patients. Outcomes after 3 months.