Postoperative complications of open lower limb fractures in pediatric patients. A single-center observational study.

Abstract

Introduction: Open lower limb fractures in children are serious injuries that require immediate surgical treatment to prevent further complications. This study aimed to determine the main postoperative complications of open lower limb fractures in pediatric patients in the Traumatology Department of a regional pediatric referral hospital.

Methodology: This retrospective observational study was conducted at Francisco de Icaza Bustamante Hospital in Guayaquil from January 2018 to December 2022. Patients aged 1 to 12 with an open fracture of the lower limb who underwent surgical treatment were included. The variables included age, sex, fracture type and location, degree of bone exposure, presence of complications, timing of complications, type of complication, type of surgical treatment, and causes leading to complications. The sample was probabilistic. Descriptive statistics and odds ratios were used.

Results: There were 220 open fracture cases (29.3% [95% CI 26.1–32.6%]). At the population level, this represents 1.45% of fractures in children (95% CI 1.30–1.60%). There were 165 (75%) fractures with postoperative complications and 55 without complications (25%). The average age was 6.6 ± 1.62 years. The most prevalent fracture was diaphyseal fracture of the tibia and fibula, with 96 cases (43.6%). Right tibial fractures are also common, accounting for 24.1% of cases, followed by right femur fractures, accounting for 10.9% of cases.

Conclusions: Different types of complications were identified, with infections, wound healing complications, and fracture malposition being the most common.