Residual Deformity and Outcome in Non-Surgically Treated Tibial Shaft Fractures in Adolescents Nearing Skeletal Maturity A Cross-Sectional Study

Main Article Content

Josiah Paolo M. Mutia, MD, MBA, DPBO
https://orcid.org/0009-0007-4093-4552
Angeli Charmeinn P. Apalisoc, MD, FPOA1
https://orcid.org/0000-0001-9137-6860

Abstract

Background. Anatomic reduction is crucial to avoid malalignment in tibial shaft fractures in adolescents quickly approaching physeal closure. While surgical treatment is becoming more common, casting and immobilization are still widely done for appropriately selected fractures. Local radiographic and clinical outcomes of non-surgical treatment need to be explored.


Objective. The primary objective of this study was to report residual lower limb deformity of tibial shaft fractures treated non-surgically in adolescents nearing skeletal maturity. The study also identified factors or fracture characteristics that may predict these deformities and reported the clinical outcomes using the Lower Extremity Functional Scale.


Methodology. This was a cross-sectional study of 31 adolescents nearing skeletal maturity at the time of injury with acute closed tibial shaft fractures treated non-surgically at the Philippine Orthopedic Center from 2017 to 2020. Skeletal maturity and residual sagittal & coronal angulation were analyzed through radiographs. Rotational alignment and leg length discrepancies were evaluated clinically. Functional outcome was measured using the Lower Extremity Functional Scale (LEFS).


Result. Coronal plane angulation (r = -0.397; p = 0.05) and leg length discrepancy (r = -0.394; p = 0.05) were inversely correlated with Lower Extremity Functional Scale (LEFS) scores. Coronal plane angulation was also correlated with ipsilateral fibular fractures (p = 0.007). Lower Extremity Functional Scale (LEFS) scores were 79.39 on average (range 75 to 80).


Conclusion. Among adolescents nearing skeletal maturity with isolated acute tibial shaft fractures, closed reduction and casting followed by close monitoring remains useful and effective.

Article Details

How to Cite
Mutia, J. P., & Apalisoc, A. C. (2024). Residual Deformity and Outcome in Non-Surgically Treated Tibial Shaft Fractures in Adolescents Nearing Skeletal Maturity: A Cross-Sectional Study . Philippine Journal of Orthopaedics. https://doi.org/10.69472/poai.2024.18
Section
Original Articles
Author Biographies

Josiah Paolo M. Mutia, MD, MBA, DPBO, Philippine Orthopedic Center, Quezon City, Philippines

Department of Orthopaedics, Philippine Orthopedic Center, Quezon City, Philippines

Regional Orthopaedic Center, Bicol Medical Center, Naga City, Philippines

Angeli Charmeinn P. Apalisoc, MD, FPOA1, Philippine Orthopedic Center, Quezon City, Philippines

Consultant, Department of Orthopaedics

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