Traumatic plastic deformation of the tibia: case report and literature review

Fractures of limbs specific to children: the experience of a Senegalese tertiary hospital

Introduction

Fractures specific to the pediatric age group represent a particular injury due to their pattern, diagnosis, management, and outcomes. In sub-Saharan Africa, studies on this particular injury are scarce. This study reports sociodemographic, diagnostic, and therapeutic aspects and outcomes of these fractures.

Methods

We conducted a descriptive cross sectional study at the pediatric surgery department of Aristide Le Dantec University Teaching Hospital in Dakar, Senegal, from January 2012 to December 2015.

Results

A fracture specific to children was diagnosed in 180, of whom 47.7% were school-aged, with 59.4% of males. The mean time from injury to the attendance of our department was 48.2 h. Domestic accidents occurred in 51.1%. A total of 243 fractures occurred, mainly on the upper limbs (75.3%), as the most affected bones were the radius (47.3%), ulna (22.6%), and tibia (13.6%). Greenstick fractures represented 46.9%, buckle fractures, 42.8%, plastic deformations 9%, and subperiosteal fractures 0.7%. In all patients, management was orthopedic, with associated analgesic treatment. No sequel nor other complication was registered.

Conclusion

Fractures proper to the child are a particular entity in children’s trauma, frequently happening in boys, with greenstick and buckle fractures being the most common. Their treatment is exclusively orthopedic, with excellent outcomes.

A Case of Acute Plastic Deformation of the Forearm in a Medieval Hispano-Mudejar Skeleton (13-14th Centuries AD)

INTRODUCTION

Acute plastic deformation refers to a traumatic bending or bowing without a detectable cortical defect.

CASE PRESENTATION AND DISCUSSION

We describe a rare case from an individual that was exhumed from the Hispano-Mudejar necropolis in Uceda (Guadalajara, Spain) dated between the 13th and 14th centuries AD. The case corresponds to an adult woman, with a bowing involvement of the left ulna and radius. After making the differential diagnosis with various pathologies likely to present with this alteration, we reached the diagnosis of acute plastic deformation of the forearm through external and radiological examination and comparison with the healthy contralateral forearm.

CONCLUSIONS

Acute plastic deformation is a rare traumatic injury, not described until the last century and only rarely described in palaeopathological contexts. We contribute a new case, the first being sufficiently documented, contributing to the knowledge and diagnosis of this type of trauma in the ancient bone, while deepening the knowledge of the living conditions of the medieval Mudejar population of Uceda.

Describing pediatric fractures in the era of ICD-10

Childhood fractures are extremely common. The recent trend is to direct certain fracture care from orthopedic specialists to primary care clinicians. However, to confirm an appropriate level of treatment, the initial diagnosis must be accurate, the description precise, and the communication between those caring for the child consistent. This review illustrates descriptors used at one institution that are based on terminology consensually created between radiologists and orthopedic surgeons for common pediatric fracture types and their displacement, and that satisfy the expanded and detailed International Statistical Classification of Diseases and Related Health Problems (ICD)-10 requirements for successful coding.