Toddler fracture
Updates to Article Attributes
Toddler fractures are minimally or undisplaced spiral fractures usually of thetibia, typically encountered in (you guessed it) toddlers.
It is a potentially difficult diagnosis to establish on account of both the symptoms and imaging findings being subtle.
The term has sometimes also been used to describe occult fractures of other lower limb bones in the same age group (e.g. fibula, cuboid, calcaneum 1,3). It is important to note that this does not include spiral femoral fractures, which should raise suspicion of non accidental injury 4.
Epidemiology
Toddler fractures typically occur between 9 months and 3 years of age 1, and are believed to be the result of new stresses placed on the bone due to recent and increasing ambulation.
Although early reports 5 suggested that tibial toddler fractures where indicative of non-accidental injury, subsequent work has suggested that this is not the case, and that the vast majority are not suspicious 4. As such they should not raise alarm when present in isolation and in the correct age group (i.e ambulating toddlers).
Clinical presentation
Children typically with vague symptoms, not clearly related to the tibia. Typically they they refuse to weight bear, and are irritable.
Radiographic features
Plain film
Conventional radiographs are all that are required, however multiple views may be necessary as the fracture is often inapparent on one or more view. The fracture is usually undisplaced.
If despite multiple views, no fracture can be identified follow up radiographs usually will demonstrate slight sclerosis and periosteal reaction.
Treatment and prognosis
Toddler fractures usually require no treatment and spontaneously heal.
History and etymology
Toddler fractures were first described by J S S Dunbar in 1964 2.
Differential diagnoses
For proximal tibia consider:
-<p><strong>Toddler fractures</strong> are minimally or undisplaced spiral fractures usually of the <a href="/articles/tibia">tibia</a>, typically encountered in (you guessed it) toddlers.</p><p>It is a potentially difficult diagnosis to establish on account of both the symptoms and imaging findings being subtle.</p><p>The term has sometimes also been used to describe occult fractures of other lower limb bones in the same age group (e.g. fibula, cuboid, calcaneum <sup>1,3</sup>). It is important to note that this does not include spiral femoral fractures, which should raise suspicion of <a href="/articles/nai">non accidental injury</a> <sup>4</sup>. </p><h4>Epidemiology</h4><p>Toddler fractures typically occur between 9 months and 3 years of age <sup>1</sup>, and are believed to be the result of new stresses placed on the bone due to recent and increasing ambulation. </p><p>Although early reports <sup>5</sup> suggested that tibial toddler fractures where indicative of non-accidental injury, subsequent work has suggested that this is not the case, and that the vast majority are not suspicious <sup>4</sup>. As such they should not raise alarm when present in isolation and in the correct age group (i.e ambulating toddlers). </p><h4>Clinical presentation</h4><p>Children typically with vague symptoms, not clearly related to the tibia. Typically they refuse to weight bear, and are irritable.</p><h4>Radiographic features</h4><h5>Plain film</h5><p>Conventional radiographs are all that are required, however multiple views may be necessary as the fracture is often inapparent on one or more view. The fracture is usually undisplaced.</p><p>If despite multiple views, no fracture can be identified follow up radiographs usually will demonstrate slight sclerosis and periosteal reaction. </p><h4>Treatment and prognosis</h4><p>Toddler fractures usually require no treatment and spontaneously heal. </p><h4>History and etymology</h4><p>Toddler fractures were first described by <strong>J S Dunbar</strong> in 1964 <sup>2</sup>. </p><h4>Differential diagnoses</h4><h6>For proximal tibia consider:</h6><ul><li>- +<p><strong>Toddler fractures</strong> are minimally or undisplaced spiral fractures usually of the <a href="/articles/tibia">tibia</a>, typically encountered in (you guessed it) toddlers.</p><p>It is a potentially difficult diagnosis to establish on account of both the symptoms and imaging findings being subtle.</p><p>The term has sometimes also been used to describe occult fractures of other lower limb bones in the same age group (e.g. fibula, cuboid, calcaneum <sup>1,3</sup>). It is important to note that this does not include spiral femoral fractures, which should raise suspicion of <a href="/articles/nai">non accidental injury</a> <sup>4</sup>.</p><h4>Epidemiology</h4><p>Toddler fractures typically occur between 9 months and 3 years of age <sup>1</sup>, and are believed to be the result of new stresses placed on the bone due to recent and increasing ambulation.</p><p>Although early reports <sup>5</sup> suggested that tibial toddler fractures where indicative of non-accidental injury, subsequent work has suggested that this is not the case, and that the vast majority are not suspicious <sup>4</sup>. As such they should not raise alarm when present in isolation and in the correct age group (i.e ambulating toddlers).</p><h4>Clinical presentation</h4><p>Children typically with vague symptoms, not clearly related to the tibia. Typically they refuse to weight bear, and are irritable.</p><h4>Radiographic features</h4><h5>Plain film</h5><p>Conventional radiographs are all that are required, however multiple views may be necessary as the fracture is often inapparent on one or more view. The fracture is usually undisplaced.</p><p>If despite multiple views, no fracture can be identified follow up radiographs usually will demonstrate slight sclerosis and periosteal reaction.</p><h4>Treatment and prognosis</h4><p>Toddler fractures usually require no treatment and spontaneously heal.</p><h4>History and etymology</h4><p>Toddler fractures were first described by <strong>J S Dunbar</strong> in 1964 <sup>2</sup>.</p><h4>Differential diagnoses</h4><h6>For proximal tibia consider:</h6><ul><li>
Systems changed:
- Trauma