![]() ![]() Level III-this is a retrospective comparative study. This reliable healing suggests that immobilization type can be at the physician and family's discretion, and that radiographic follow-up may be unnecessary for treatment planning. In our cohort, initial immobilization of a toddler's fracture in a boot may allow faster return to weight-bearing, but fractures were universally stable regardless of immobilization type, and nearly all regained weight-bearing by 4 weeks. Patients received an average of 2.5 two-radiograph series no radiographs were noted to affect treatment decisions in follow-up. No fractures displaced at any time point, including 7 that had received no immobilization. 2.8 wk, P=0.04), but there were no other differences between immobilization type. There was an earlier return to weight-bear for those initially treated in a boot compared with short leg cast (2.5 vs. At final follow-up, 184 (96%) were known to be weight-bearing, with 98% of these by 4 weeks. Of the 75 without initially visible fractures, 70 (93%) had robust periosteal reaction on follow-up, and none were diagnosed as anything further. There were 606 subjects with lower leg radiographs, with 192 meeting study criteria: 117 (61%) with an initially visible fracture and 75 (39%) without. However, when evaluated in clinical context, classic imaging findings can support allegations of abuse. Treatment may be nonoperative or operative depending on the fracture morphology, age of the patient, and associated injuries. Diagnosis can be confirmed with plain radiographs of the tibia. Subjects were compared with regard to clinical and radiographic presentation initial and subsequent immobilization and clinical and radiographic follow-up. Certain fractures sustained during childhood are typically related to accidental trauma, such as spiral fractures of the tibia in newly ambulating toddlers and clavicular fractures in children within a broad age range. 9 Topic Podcast Images summary Pediatric Tibial Shaft Fractures are the third most common long bone fracture in children. Those who fulfilled the criteria of a nondisplaced spiral tibia fracture, without fibula or physeal injury, were included in data collection, as were subjects with a negative initial radiograph that were treated presumptively as a toddler's fracture. ![]() We aimed to compare immobilization type with respect to displacement and time to weight-bear, as well as determine the usefulness of follow-up radiographs.Ī 3-year retrospective chart review of all children aged 9 months to 4 years who had a lower leg radiograph was performed. However, there is no widely accepted type of immobilization, expected time to weight-bear, nor guidelines for radiographic monitoring. The toddler's fracture is a common pediatric nondisplaced spiral tibia fracture that is considered stable with a course of immobilization. ![]()
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