Toddler's fracture: Difference between revisions
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==Treatment== | ==Treatment== | ||
*Definite fracture | *Definite fracture | ||
**Immobilize in long leg splint | **Immobilize in long leg splint (knee flexed to provide rotational control and prevent weight bearing) | ||
**Ortho f/u next day for definitive casting | **Ortho f/u next day for definitive casting. Usually takes 3-4 weeks for healing without further intervention. | ||
**Serial radiographs to monitor for developing deformity (ie leg length discrepancy or varus/valgus angular deformity). | |||
*High suspicion despite negative x-ray | *High suspicion despite negative x-ray | ||
**Immobilize and f/u w/ bone scan or repeat x-ray in 1wk | **Immobilize and f/u w/ bone scan or repeat x-ray in 1wk | ||
Revision as of 08:59, 31 December 2013
Background
- Subset of childhood accidental spiral tibial (CAST) fractures, where it is a minimally displaced distal spiral tibial fracture typically encountered in ambulating toddlers (9 months - 3 years) due to low energy trauma with rotational component.
Clinical Features
- History of an otherwise healthy child, who was ambulating, falls and is then non-ambulatory or has painful ambulation.
- Usually pain with palpation and rotation of distal tibia
- Swelling may be minimal or absent
Diagnosis
- May need oblique view if strong suspicion but AP/lat are negative
Treatment
- Definite fracture
- Immobilize in long leg splint (knee flexed to provide rotational control and prevent weight bearing)
- Ortho f/u next day for definitive casting. Usually takes 3-4 weeks for healing without further intervention.
- Serial radiographs to monitor for developing deformity (ie leg length discrepancy or varus/valgus angular deformity).
- High suspicion despite negative x-ray
- Immobilize and f/u w/ bone scan or repeat x-ray in 1wk
See Also
Source
Tintinalli