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Bilateral tibial fractures in properly restrained toddlers involved in motor vehicle collisions: case reports
R Uphold1, R Harvey, W Misselbeck
1Department of Surgery, College of Medicine, University of Vermont, Burlington.
Insights
Child safety seats significantly reduce injuries in car crashes. However, even properly restrained toddlers can sustain bilateral tibial fractures, sometimes with subtle symptoms, requiring a high index of suspicion from medical professionals.
Area of Science:
- Pediatric Orthopedics
- Trauma Surgery
- Public Health
Background:
- Child restraints, particularly safety seats, are proven to decrease morbidity and mortality in pediatric motor vehicle crash victims.
- Existing literature indicates a low incidence of extremity fractures in properly restrained toddlers.
Observation:
- A review of 10 restrained infants in car crashes admitted to the hospital revealed 4 cases of leg fractures.
- Two specific cases involved bilateral tibial fractures in toddlers who were correctly restrained.
Findings:
- The typical clinical signs of fracture were minimal or absent in the reported cases of bilateral tibial fractures.
- This suggests that even with appropriate restraint use, significant lower extremity injuries can occur.
Implications:
- A high index of suspicion is crucial when evaluating toddlers involved in motor vehicle crashes, regardless of restraint use.
- These findings highlight the potential for serious injuries even in seemingly well-protected children, emphasizing the need for thorough medical assessment.
Abstract:
It is well documented that the use of child restraints, specifically child safety seats, can reduce morbidity and mortality in young victims of motor vehicle crashes. Literature review reveals few extremity fractures in properly restrained toddlers. Of 10 restrained infants involved in car crashes admitted to our hospital, 4 had leg fractures. We report 2 cases of bilateral tibial fractures in restrained toddlers in which the usual clinical signs of fracture were minimal or lacking. A high index of suspicion must be maintained in evaluating even properly restrained toddlers in motor vehicle crashes.