Ankle
Toddler Fracture
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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
Fracture
s)
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
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