Toddler's fracture

Background

• Isolated spiral fx of distal tibia in a toddler

Clinical Features

• Child limping or refusing to bear wt
• 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
  • Ortho f/u next day for definitive casting
• High suspicion despite negative x-ray
  • Immobilize and f/u w/ bone scan or repeat x-ray in 1wk

Source

Tintinalli