{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T12:04:58Z","timestamp":1788350698795,"version":"build-2803163510"},"reference-count":41,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,2]]},"abstract":"\n Purpose of review<\/jats:title>\n To describe surgical treatment options for pediatric tibial shaft fractures which are the third most common pediatric long bone fracture. Management of these injuries is dictated by fracture location, fracture pattern, associated injuries, skeletal maturity, and other patient-specific factors. Although most pediatric tibial shaft fractures can be treated nonoperatively, this review provides an update on surgical treatment options when operative intervention is indicated.<\/jats:p>\n <\/jats:sec>\n \n Recent findings<\/jats:title>\n Advances in surgical implants and techniques affords a wide range of options for the surgical treatment of pediatric tibial shaft fractures. Flexible intramedullary nailing is gaining wide adoption for acute surgical treatment. Recent studies support cross-sectional imaging for further evaluation and scrutiny of fracture patterns suspicious for intraphyseal or intra-articular extension. Grade I open tibial shaft fractures may be safely treated with irrigation and debridement in the emergency department; however, no high-level comparative studies have been performed to make any definitive conclusions regarding the effectiveness of this treatment strategy.<\/jats:p>\n <\/jats:sec>\n \n Summary<\/jats:title>\n Tibial shaft fractures are common injuries in pediatric patients. Management is dictated by fracture location, fracture pattern, associated injuries, patient age, and other patient-specific factors. Surgical intervention is indicated for fractures that are open, irreducible, have failed nonoperative management, are associated with compartment syndrome, or in the multiply injured patient. Surgical treatment options include flexible intramedullary nailing, plate osteosynthesis, external fixation, and rigid intramedullary nailing. Recent literature has shown increased rates of flexible intramedullary nailing. All operative and nonoperative management options can result in complications including compartment syndrome, infection, delayed union, nonunion, malunion, limb length discrepancy, and symptomatic hardware. Most pediatric patients go on to uneventful union with excellent final outcomes and return to full activities.<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/mop.0000000000000704","type":"journal-article","created":{"date-parts":[[2018,11,17]],"date-time":"2018-11-17T16:06:21Z","timestamp":1542470781000},"page":"92-102","source":"Crossref","is-referenced-by-count":33,"title":["Evidence-based update on the surgical treatment of pediatric tibial shaft fractures"],"prefix":"10.1097","volume":"31","author":[{"given":"Aristides I.","family":"Cruz","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Hasbro Children's Hospital, Warren Alpert Medical School of Brown University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy E.","family":"Raducha","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Warren Alpert Medical School, Brown University, Providence, Rhode Island"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ishaan","family":"Swarup","sequence":"additional","affiliation":[{"name":"Pediatric Orthopaedic Surgery Service, Hospital for Special Surgery, Weill Cornell Medical College, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan M.","family":"Schachne","sequence":"additional","affiliation":[{"name":"Pediatric Orthopaedic Surgery Service, Hospital for Special Surgery, Weill Cornell Medical College, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter D.","family":"Fabricant","sequence":"additional","affiliation":[{"name":"Pediatric Orthopaedic Surgery Service, Hospital for Special Surgery, Weill Cornell Medical College, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20230918","first-page":"1874","article-title":"Fractures of the shaft of the tibia and fibula","author":"Mooney","year":"2015","journal-title":"Rockwood & Wilkins fractures in children"},{"key":"R2-20230918","doi-asserted-by":"crossref","first-page":"746","DOI":"10.1016\/j.injury.2014.12.027","article-title":"Incidence and epidemiology of tibial shaft fractures","volume":"46","author":"Larsen","year":"2015","journal-title":"Injury"},{"key":"R3-20230918","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1097\/01241398-199407000-00005","article-title":"The relationships of skeletal injuries with trauma score, injury severity score, length of hospital stay, hospital charges, and mortality in children admitted to a regional pediatric trauma center","volume":"14","author":"Buckley","year":"2018","journal-title":"J Pediatr Orthop"},{"key":"R4-20230918","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1302\/0301-620X.71B4.2768307","article-title":"Tibial shaft fractures treated with functional braces. 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