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Abstract: Pediatric Open Tibial Fractures in the United States: Analysis of Incidence, Operative Strategies and Resource Utilization over 15 Years

Plast Reconstr Surg Glob Open · 2017 · PMC5636526

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a clear trendno p-value reported
CONCLUSION: There is a clear trend toward centralization of care; however, there has been no improvement in complication rates, with a decrease in flap reconstruction.

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Quoted from the open-access full text in Europe PMC under the licence the publisher applied. The sentence is reproduced exactly as published; the emphasis is ours.