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European Journal of Trauma and Emergency Surgery

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Open Access 22-12-2022 | Tibia Fracture | Original Article

Greenstick fractures of the proximal metaphyseal tibia: a retrospective multicenter study on the outcome after non-surgical or surgical treatment and the occurrence of posttraumatic tibia valga

Authors: Annabelle Weigert, Justus Lieber, Daniel Buergener, Kay Grosser, Peter Strohm, Peter P. Schmittenbecher, Joern Zwingmann, the Section of Pediatric Traumatology (SKT) of the German Association of Traumatologists (DGU)

Published in: European Journal of Trauma and Emergency Surgery | Issue 3/2023

Abstract

Purpose

This study investigates the occurrence of (progressive) posttraumatic valgus deformity after proximal metaphyseal greenstick fractures of the tibia in young children, and whether non-surgical or surgical treatment influences the outcome.

Methods

A retrospective multi-center study was conducted including surveys and X-rays of patients < 12 years of age with a fracture of the proximal tibia. In patients with greenstick fractures, the medial proximal tibia angle (MPTA; defined as the angle of the tibial axis and the joint-line of the knee) was measured at trauma, short-term follow-up (st-FU), and long-term FU (lt-FU) as defined for the 2 groups of non-surgically and surgically treated patients.

Results

Of a total of 322 fractures, 91 were greenstick fractures. Of these, 74 were treated non-surgically and 17 were treated surgically. The mean MPTA at trauma of non-surgically treated patients was 91.14°, and of surgically treated patients was 95.59° (p = 0.020). The MPTA in non-surgically treated patients significantly increased from the timepoint of trauma to st-FU (92,0°; p = 0.030), and lt-FU (92,66°, p = 0.016). In surgically treated patients, the MTPA improved after trauma to st-FU (94.00°; p = 0.290), and increased again to lt-FU (96.41°; p = 0.618).

Conclusion

Progressive valgus deformity after greenstick fractures of the proximal tibia occurred in both non-surgically and surgically treated patients. In non-surgically treated patients, this was of statistical, but not clinical significance. In surgically treated patients, progressive valgus was observed after metal removal for an unknown reason. Therefore, surgery for proximal greenstick fractures of the tibia in this age group has only limited effect and may be indicated only in selected cases. Further studies are needed to explain the responsible mechanisms.

Level of evidence

III, retrospective analysis.

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Title: Greenstick fractures of the proximal metaphyseal tibia: a retrospective multicenter study on the outcome after non-surgical or surgical treatment and the occurrence of posttraumatic tibia valga
Authors: Annabelle Weigert
Justus Lieber
Daniel Buergener
Kay Grosser
Peter Strohm
Peter P. Schmittenbecher
Joern Zwingmann
the Section of Pediatric Traumatology (SKT) of the German Association of Traumatologists (DGU)
Publication date: 22-12-2022
Publisher: Springer Berlin Heidelberg
Keywords: Tibia Fracture
Proximal Tibia Fractures
Published in: European Journal of Trauma and Emergency Surgery / Issue 3/2023
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-022-02181-w

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Greenstick fractures of the proximal metaphyseal tibia: a retrospective multicenter study on the outcome after non-surgical or surgical treatment and the occurrence of posttraumatic tibia valga

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

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