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Toddler Fracture , tibial fracture in a child- Everything You Need To Know - Dr. Nabil Ebraheim

Educational video describing Toddler fractures. Nondisplaced spiral or oblique fractures of the tibial shaft may occur in children less than 3 years of age as they begin to walk. In children, the diaphysis of the tibia has a great amount of woven bone (soft or weak bone) rather than osteon bone, which is hard cortical bone. A thick periosteum prevents displacement of the fracture. This fracture occurs mostly with twists and falls and usually has a rational component. The fractures usually involve the tibia. It is usually a low energy fracture of the distal tibia. Differential diagnosis •Child abuse: occurs in children not walking yet. •Osteomyelitis •Transient synovitis. The child is usually limping and cannot walk without pain in the leg. Initial x-rays are usually normal and after 1-2 weeks a callus develops. New bone formation is an indication of an occult fracture. Look for bowing of the fibula on the x-ray. It is better to get internal oblique view on x-rays if you suspect a toddler fracture. If the x-rays are negative, get a bone scan. Bone scan is usually not needed, but it will make the family feel better. Treatment •Rule out constitutional signs •Casts for 3-4 weeks •Appy the cast and see the patient in 1-2 weeks. Ultrasound is useful in the diagnosis of toddler fractures in the emergency room. Ultrasound can detect a fracture hematoma or changes in the periosteum. This diagnostic modality may become popular in the future. Some physicians recommend the use of a long leg cast in children with history of acute injury. These children are unable to walk and have a painful limp. They have negative x-rays. Before you apply the cast, check to see that there is no constitutional signs. Become a friend on facebook:   / drebraheim   Follow me on twitter: https://twitter.com/#!/DrEbraheim_UTMC Background music provided as a free download from YouTube Audio Library. Song Title: Every Step