OPEN FRACTURES OF THE TIBIA AND FEMUR IN CHILDREN

Forty-seven children with 32 open tibial fractures, 11 open femoral fr actures, and six closed tibial fractures with compartment syndrome, wh ich were surgically opened, were assessed for the time to union and in cidence of nonunion and infection. Treatment varied with fracture seve rity and patient age. Tibial external fixators were supplemented by sh ort-leg casts, and fixators were removed at an average of 7 weeks. No child required further surgery to achieve union. There was one (2%) de layed union and no nonunions. Three fractures (6%) developed infection s. No pin-tract infections occurred in tibial fractures treated with e xternal fixation with casting. The relation between age and time to un ion was statistically significant. In open fractures without segmental bone loss or soft-tissue loss requiring major reconstruction, bony he aling can be expected within 6 months.