The aims of treatment are:
Grade C0, C1 and C2 fractures may be treated with a plaster cast from mid-thigh to mid-metatarsals with the knee slightly bent.
Closed fractures which are displaced should be realigned as a closed procedure under general anaesthesia and X-ray screening. Angulation should be within 7 degrees of perfect; rotation should be perfect. A plaster is applied as described above.
With the plaster applied, the position of the bones is assessed radiographically. The leg is elevated and the patient observed for 72 hr. If the leg swells the cast is split. The fracture is checked radiographically after 2 weeks. The cast may be removed after 8 weeks for a child and 16 weeks for an adult.
If the position of the bones is unacceptable with a plaster cast then external fixation, plate fixation or intramedullary nailing are required.
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