spiral fracture tibia toddler

The toddler's fracture is a distinct entity among tibial shaft fractures. Fracture is not displaced. These are known to be actually quite hard and difficult to spot on an x-ray unless the angle is right or even in spite of the angle of view being right. Involves distal half to distal third of the tibia. Since the broken bones in a spiral fracture have jagged edges, the healing process can become more complicated. Answer Toddler's fracture, also called childhood accidental spiral tibial fracture or CAST fracture, is a fracture unique to ambulatory infants and young children. Toddler's fractures are bone fractures of the distal (lower) part of the shin bone in toddlers (aged 9 months-3 years) and other young children (less than 8 years). They are often difficult to diagnose due to the absence of witnessed trauma and because initial radiographs may appear normal. It is caused by a twisting injury while tripping, stumbling, or falling. Before choosing a treatment option, the limb will need to be examined by a healthcare professional. The fracture is found in the distal two thirds of the tibia in 95% of cases, is undisplaced and has a spiral pattern. The injury may also result in detached bone fragments making treatment harder. An X-ray may be ordered to confirm that a fracture has occurred and to determine whether it is a spiral or other type. A toddler fracture is a minimally or undisplaced spiral fracture, usually of the tibia, typically encountered in toddlers. A spiral fracture is commonly known as a toddler's fracture, due to a young child's frequency of falling. It occurs after low-energy trauma, sometimes with a rotational component. Toddler’s Fracture. Initial radiographs in patients with suspected toddler’s fracture have been reported to be negative up 59–66% of the time. It is defined as a minimally displaced or undisplaced spiral fracture, usually affecting the distal shaft of the tibia, with an intact fibula. A bone scan alternatively may be required to show the toddler’s fracture. Spiral or oblique pattern. A sudden twisting or severe wrenching of the tibia or the shin bone can cause a fracture to occur in the spiral pattern. It is a potentially difficult diagnosis to establish on account of both the symptoms and imaging findings being subtle. On plain film, toddler’s fractures are classically described as a spiral or oblique fracture through the distal third of the tibia. Toddler's fracture, as defined in 1964, is a non-displaced, isolated, distal-third diaphyseal spiral tibial fracture in children between 9 months and 3 years of age and therefore constitutes the main part of the age group from 0 to 4 years, as presented in Figures 2A,B, followed by the oblique fracture of the tibia (42t-D/5.1 and 42t-D/5.2). In an effort to find if one particular fracture is more common among abused children, researchers have found that they occur equally in the femur (thigh bone), tibia (lower leg), and humerus (upper arm). Also known as “Childhood Accidental Spiral Tibial (CAST) fracture.” Typically seen in ambulatory toddlers (9 months to 3 years). Spiral fracture treatment depends on how severe the break is and the amount of damage to the surrounding tissues and blood vessels. This is a radiographically subtle nondisplaced spiral fracture of the tibia in a child less than 3 years of age, also known as a toddler’s fracture or childhood accidental spiral tibia (CAST) fracture.. Toddler ’s Fracture • Isolated tibia fracture (fibula intact), usually distal half of shaft • Very common in walking toddlers • Usually twisting injury, hence spiral fx pattern • Stable injuries given robust periosteum • Treatment: – If distal, short leg cast for 3 -4 weeks – If proximal, above knee cast with knee flexed 10 Initial radiographs are frequently negative, but a follow-up film 1-2 weeks after presentation will often confirm a fracture by revealing periosteal reaction and signs of fracture healing.