AO Surgery Reference update: New pediatric trauma content—Proximal tibia

The content of the pediatric proximal tibial fracture management has been authored by Philip Henman (UK), Mamoun Kremli (SA), and Dorien Schneidmüller (DE) with Fergal Monsell (UK) as editor.

This module includes a detailed consideration of all patterns of physeal injury using a spectrum of techniques. A description of bridge plating has also been introduced, which is relevant to the older child in addition to specialist techniques, which combine conventional osteosynthesis with arthroscopy to manage intraarticular fractures.
There is also a section that considers the management of intraarticular ligament injuries, as this is becoming more prevalent, particularly in the adolescent female.

What does the revision include?

This module covers the treatment options for:

• Salter-Harris type-I–IV fractures
• Avulsion of tibial spine and posterior cruciate ligament
• Metaphyseal fractures
• Avulsion of the apophysis

This includes detailed procedures on K-wire and screw fixation, external fixation, plate fixation, in addition to nonoperative management with casting and splinting.

Suture fixation of an avulsed tibial spine and cerclage compression wiring of an apophyseal avulsion are also covered.

The module is complemented with pages dedicated to patient assessment, complications, technical failures, and compartment syndrome.