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Toddler Fracture
Aka: Toddler Fracture, Toddlers Fracture, Toddler's Fracture
- See Also
- Pediatric Limp
- Definition
- Toddler Fracture
- Distal tibia spiral Fracture in ambulatory children under age 3 years
- Epidemiology
- Most common Fracture in age 9 months to 3 years that present with a limp (29%)
- Not suspicious for abuse (contrast with other spiral Fractures)
- Presentation
- Typically child Running, falls, and is then non-ambulatory or with painful ambulation
- Typically follows minimal or unwitnessed Trauma
- Signs
- Provocative maneuvers
- Tenderness to palpation over the mid to distal tibia
- Passive dorsiflexion of ipsilateral foot
- Tibia twisting by rotating foot while holding knee stable
- Differential Diagnosis
- See Pediatric Limp
- Imaging: Ankle XRay
- Spiral Fracture of distal tibia (best seen on internal oblique view)
- May be occult Fracture (normal initial xray in 40% of cases)
- Repeat XRay in 7-10 days
- Management
- Typical management
- Posterior long leg splint for 5-7 days, THEN
- Long leg cast
- Some recommend below knee walking cast for 3 weeks
- References
- (2018) Crit Dec Emerg Med 37(5): 3-14
- Latessa (2012) AAFP Board Review Express, San Jose