As such they should not raise the alarm when present in isolation and the correct age group (i.e. ambulating toddlers). Toddler fractures typically occur between nine months and three years of age 1 and are believed to be the result of new stresses placed on the bone due to recent and increasing ambulation.Īlthough early reports 5 suggested that tibial toddler fractures were indicative of non-accidental injury, subsequent work has suggested that this is not the case and that the vast majority are not suspicious 4. Buckle fractures are caused by compressive loading. It is important to note that this does not include spiral femoral fractures, which should raise suspicion of non-accidental injury 4. Toddlers fractures are usually undisplaced spiral or oblique fractures of the distal half of the tibia, usually with an intact fibula. This image shows a buckle fracture of the tibial metaphysis. It occurs after low-energy trauma, sometimes with a rotational component. The fracture is found in the distal two thirds of the tibia in 95 of cases, is undisplaced and has a spiral pattern. The name derived from the shape of the fracture along the diaphysis of a long bone. Toddlers fractures are bone fractures of the distal (lower) part of the shin bone in toddlers (aged 9 months-3 years) and other young children (less than 8 years). Six of 15 (40 ) tibia shaft fractures in children aged <1 year were reported for abuse. A toddlers fracture occurs in children 1 to 3 years. None of five (0 ) femoral fractures in children aged 12 years were reported for abuse (p 0.297). A toddlers fracture is a spiral fracture of the tibia that is perfectly or nearly perfectly aligned. The mechanism of injury was indirect in 13 fractures. Results: Twenty-six children met these criteria and were included in the study. Fractures of the distal tibial diaphysis, toddlers fractures, and pathologic fractures were excluded. The term has sometimes also been used to describe occult fractures of other lower limb bones in the same age group (e.g. Spiral fractures typically occur in children, with the tibia being a common site. Femoral shaft fractures consisted of eight transverse and three spiral fractures. The patients with fractures of the distal tibial metaphysis who had been followed until healing were included.
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