Toddler fracture

Case contributed by Dr Stefan Lazic

Presentation

Landed awkwardly down a playground slide. Refusing to weight-bear on the left lower limb.

Patient Data

Age: 3 years
Gender: Female
X-ray

Subtle oblique lucency across proximal tibial shaft the postero-anteriorly. 

Two weeks later

X-ray

The oblique lucency across proximal tibial shaft the postero-anteriorly is more obvious on the lateral projection two weeks after injury. New periosteal reaction posteriorly, also best seen on the lateral. 

Case Discussion

Initial x-rays were reported as normal and without a red dot. The patient was kept in cast and non-weight-bearing and was followed up in the clinic due to a high index of suspicion. Repeat x-rays 2 weeks after injury in the clinic show callus formation.

This case hopefully highlights the high index of suspicion required in the diagnosis of toddler's fractures.

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