Tibia fracture (peds)

Toddler's Fracture

Background

• Also known as childhood accidental spiral tibial fracture
• Occurs in pts <5yr after twisting foot while planted on same leg

Clinical Features

• Inability to bear wt

Diagnosis

• May only present as faint oblique line on AP view

Management

• If strong clinical suspicion despite normal radiographs splint child above knee to foot

Tibial Spine Fracture

Background

• Avulsion fx of tibial spine is equivalent to ACL rupture in adult

Management

• Nondisplaced
  • Managed conservatively w/ immobilization and ortho f/u
• Displaced
  • Immediate ortho consult

Tibial Tuberosity Fracture

Background

• Due to contraction of quadriceps against fixed leg
• Type I
  • Fx through the small distal portion of the tibial tuberosity
• Type II
  • Occur after coalescence of secondary ossification centers of tuberosity to the metaphysis
• Type III
  • Splits epiphysis of the tuberosity from the epiphysis of the proximal tibia
  • At risk for compartment syndrome

Management

• Types I and II
  • Immobilization
• Displaced type II and type III
  • Immediate ortho consult

See Also

• Fractures (Main)

Source

Tintinalli