Tibia fracture (peds)
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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
Differential Diagnosis
Pediatric Tibial Fractures
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
Differential Diagnosis
Pediatric Tibial Fractures
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
Differential Diagnosis
Pediatric Tibial Fractures
Management
- Types I and II
- Immobilization
- Displaced type II and type III
- Immediate ortho consult
See Also
Source
Tintinalli