RT Journal Article
SR Electronic
T1 Fifteen-minute consultation: The toddler’s fracture
JF Archives of disease in childhood - Education & practice edition
JO Arch Dis Child Educ Pract Ed
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP 94
OP 99
DO 10.1136/archdischild-2020-319758
VO 106
IS 2
A1 Nils Wijtzes
A1 Hannah Jacob
A1 Katie Knight
A1 Steffi Thust
A1 Gayle Hann
YR 2021
UL http://ep.bmj.com/content/106/2/94.abstract
AB 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.