Fifteen-minute consultation: The toddler's fracture.
analgesia
child abuse
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
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
94-99Informations 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.