The Toddler's Fracture
Yiqiao Wang1, Meagan Doyle2, Kevin Smit3
1From the University of Toronto Faculty of Medicine, Toronto.
Insights
The toddler's fracture, a common childhood injury, is best diagnosed through physical exam, as X-rays are often normal. Treatment involves brief immobilization, leading to excellent recovery outcomes for children.
Area of Science:
- Pediatric Orthopedics
- Emergency Medicine
- Radiology
Background:
- Tibial toddler's fractures present as acute lower extremity pain or limping in young children.
- Diagnosis and management can be challenging due to a broad differential diagnosis.
Purpose of the Study:
- To provide an overview of the toddler's fracture.
- To guide clinicians by summarizing current literature on diagnosis and management.
Main Methods:
- Literature analysis of PubMed database from 1964 to 2018.
- Focus on diagnosis and management of toddler's fractures.
Main Results:
- Diagnosis relies primarily on history and physical examination; radiographs are frequently negative.
- Treatment involves short-term immobilization (cast, splint, or no support).
- Near-universal successful healing and return to normal activities are observed.
Conclusions:
- Toddler's fractures are stable with an excellent prognosis.
- Opportunities exist to enhance diagnostic and treatment protocols for optimal clinical management.
Objective:
The tibial toddler's fracture is an important diagnosis in both emergency and urgent care, presenting as acute onset lower extremity pain or limping in a young child. Diagnosis and management may be challenging because of an extensive differential diagnosis. The objectives of this study were to provide an overview of the toddler's fracture and to guide clinicians by summarizing up to date literature for both diagnosis and management this common condition.
Methods:
This study analyzed literature from the PubMed database from the years of 1964 to 2018. The main focus was on the diagnosis and management of the toddler's fracture.
Results:
This review demonstrates that diagnosis is primarily made through history and physical examination, as radiographs are often negative at initial presentation. Treatment involves a short period of immobilization, which can be facilitated through the use of a cast, a splint, or no external support. Successful healing and a full return to normal activities and development are near universal.
Conclusions:
Although a stable fracture with an excellent prognosis, opportunities exist to improve toddler's fractures diagnosis and treatment protocols, to optimize clinical management.
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