Fifteen-minute consultation: The toddler's fracture.


Journal

Archives of disease in childhood. Education and practice edition
ISSN: 1743-0593
Titre abrégé: Arch Dis Child Educ Pract Ed
Pays: England
ID NLM: 101220684

Informations de publication

Date de publication:
04 2021
Historique:
received: 26 05 2020
revised: 16 06 2020
accepted: 23 06 2020
pubmed: 21 8 2020
medline: 16 11 2021
entrez: 21 8 2020
Statut: ppublish

Résumé

The toddler's fracture is a distinct entity among tibial shaft fractures. It is defined as a minimally displaced or undisplaced spiral fracture, usually affecting the distal shaft of the tibia, with an intact fibula. They are often difficult to diagnose due to the absence of witnessed trauma and because initial radiographs may appear normal. Moreover, the presenting complaint (a non-weight bearing child) has a wide differential diagnosis. A detailed history and examination, together with additional imaging and other investigations, is crucial to diagnose a toddler's fracture. Analgesia and immobilisation are the mainstays of treatment, with follow-up in fracture clinic recommended. Inflicted injury (Note: this article will use the term inflicted injury which is also called non-accidental injury. In the field of safeguarding, there is a move away from using the term 'non-accidental injury' due to misinterpretation of the term as being less serious than 'abusive injury' and that in child protection reports the term can be easily misread or mistyped as 'accidental' injury) should always be considered when red flags for child abuse are present. In this article, we aim to cover the differential diagnoses for toddler's fracture including indicators that might suggest an inflicted injury.

Identifiants

pubmed: 32817067
pii: archdischild-2020-319758
doi: 10.1136/archdischild-2020-319758
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

94-99

Informations de copyright

© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

Auteurs

Nils Wijtzes (N)

Department of Paediatrics, North Middlesex University Hospital, London, UK.

Hannah Jacob (H)

Department of Paediatrics, North Middlesex University Hospital, London, UK.

Katie Knight (K)

Paediatric Emergency Medicine, North Middlesex University Hospital, London, UK.

Steffi Thust (S)

Radiology, University College London Hospitals NHS Foundation Trust, National Hospital for Neurology and Neurosurgery, London, UK.

Gayle Hann (G)

Department of Paediatrics, North Middlesex University Hospital, London, UK gaylehann@yahoo.com.

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