UpToDate – Tibial and fibular shaft fractures in children (2016) Management of Toddler’s Fractures in the Pediatric Emergency Department. Management of the Toddler’s fracture with and without initial radiological evidence. ![]() Royal Children’s Hospital Guidelines – Tibial Shaft Fractures. (2019) An updated approach to toddler fractures. (2006), Sonographic diagnosis of toddler’s fracture in the emergency department. Journal of the Canadian Association of Radiologists, Sep 15, 136-144.įox, S. 102-Bĭunbar, J.S., Owen, H.F., Nogrady, M.B., McLeese, R., (1964) Obscure Tibial Fracture of Infants – The Toddler’s Fracture. (2020) Point-of-care Ultrasound in the Emergency Department may provide more accurate diagnosis of toddler fractures than radiographs: A pilot study. (2019) Toddler’s Fractures: Time to Weight-bear with Regard to Immobilization Type and Radiographic Monitoring. Canadian family physician Medecin de famille canadien, 64(10), 740–741.īauer, J.M., Lovejoy, S.A. Further studies are currently underway, so watch this space!Īlqarni, N., & Goldman, R. There is now a move towards recommending immobilisation in a CAM boot, short leg cast, or splint rather than in a long leg cast. Sapru and Cooper also found no complications with management in or out of a cast. Even when considering the seven children in this study who received no immobilisation, none of the fractures shifted. It was a mean of 4.1 days for the little ones not immobilised compared to 27.0 days for the smallies in a boot and a whopping 27.5 days for those in a cast or splint.Īnother retrospective study by Bauer and Lovejoy of 192 children aged nine months to 4 years, meeting criteria for a toddler’s fracture, showed an earlier return to weight-bearing in those immobilised with a CAM boot compared with a short leg cast ( 2.5 vs 2.8 weeks). also found that children who were not immobilised walked much earlier than those who were immobilised in a controlled ankle movement (CAM) boot or splint. Skin breakdown was reported in 17% of children, all of whom were in a splint or cast. Those not immobilised had fewer follow up appointments and fewer repeat radiographs. ![]() But… a series of 75 children with radiographic evidence of toddler’s fractures, by Schuh et al., looked outcome following a variety of treatments (cast/splint, controlled ankle movement boot, or no immobilisation). ![]() They show that children with confirmed toddler’s fractures are more likely to be immobilised. The standard treatment is a long leg back slab followed by a long leg walking cast.Ī number of retrospective studies have looked at rates of immobilising toddler’s fractures when the diagnosis is either confirmed or presumed. Toddlers’ fractures do not need to be reduced, and the management is mainly supportive for 3-4 weeks.
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