Management of Toddler's Fracture: A Systematic Review With Meta-Analysis.

Area of Science:

• Pediatric Orthopedics
• Musculoskeletal Injuries

Background:

• Toddler's fractures (TF) are common pediatric leg injuries.
• Current treatment often involves immobilization, but its necessity is debated.

Purpose of the Study:

• To compare fracture-related adverse outcomes between immobilization and no immobilization for toddler's fractures.
• To evaluate health services utilization differences between these treatment strategies.

Main Methods:

• Systematic literature search across major databases (MEDLINE, Embase, Cochrane).
• Inclusion of retrospective studies with quality assessment by two independent authors.
• No restrictions on language, publication status, or location.

Main Results:

• Four low-quality retrospective studies (355 participants) met inclusion criteria.
• No significant difference in fracture-related adverse outcomes between immobilization and no immobilization.
• No immobilization group showed fewer radiographs and outpatient visits, but a trend towards more repeat ED visits.

Conclusions:

• No immobilization may be a safe alternative for toddler's fractures.
• High-quality evidence is required to guide clinical decision-making.
• Future research should incorporate patient recovery, pain, and caregiver perspectives.