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Occult fractures in preschool children
1Department of Radiology, Children's Hospital of Pittsburgh, Pennsylvania 15213.
Insights
Radiographs of acutely limping infants and toddlers revealed fractures in 20% of cases. The study recommends imaging the pelvis and both lower extremities, including feet, for suspected occult trauma.
Area of Science:
- Pediatric Radiology
- Orthopedic Trauma
Background:
- A limp in infants and toddlers can indicate underlying fractures.
- Accurate diagnosis is crucial for timely intervention and management.
Purpose of the Study:
- To determine the incidence and common sites of fractures in acutely limping young children.
- To evaluate the diagnostic yield of radiographic examinations in this population.
Main Methods:
- Retrospective analysis of 500 consecutive radiographic examinations.
- Inclusion of infants and toddlers presenting with acute limping.
Main Results:
- Fractures were identified in 100 out of 500 (20%) children.
- Most common fracture sites included tibia/fibula (56 cases) and femur (30 cases).
- Pelvic and foot fractures, particularly metatarsals (11 cases), were also observed.
Conclusions:
- Fractures are a significant cause of acute limping in young children.
- Radiographs of the pelvis and both lower extremities, including the feet, are recommended when occult trauma is suspected and clinical localization is difficult.
Abstract:
Five hundred consecutive radiographic examinations of acutely limping infants and toddlers were analyzed retrospectively. One hundred of the 500 (20%) had a fracture as the underlying etiology. Although the most common sites of involvement were the tibia/fibula (56 cases) and femur (30 cases), fractures in the pelvis and feet, notably the metatarsals (11 cases), also were seen. We therefore recommend obtaining radiographs of the pelvis and both lower extremities including the feet, when occult trauma is suspected and the exact area of injury cannot be pinpointed clinically.