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Toddler Tibia Fracture - Inclusion and Exclusion

Inclusion Criteria:

  • Patients aged 1 to 4 years
  • Not bearing weight
  • Low energy mechanism, defined as:
    • Fall from standing
    • Trip and fall Injury at the bottom of a slide
  • Stable tibial shaft or distal tibia fracture, defined as:
    • No cortical displacement
    • No fracture shortening
    • No angulation
    • No malrotation
    • Intact fibula
    • Can be spiral or buckle fracture pattern
    • Suspected toddler’s fracture

Exclusion criteria:

  • Patients with multisystem trauma
  • High energy mechanism
  • Infection concern (fever and limited weight-bearing, elevated inflammatory markers)
  • Neoplasm concern
  • Non-accidental trauma
  • Non-ambulatory
  • Multiple fractures
  • Metabolic bone disease
  • Any amount of cortical displacement
  • Any amount of fracture shortening
  • Any amount of angulation
  • Reduction required
    • Associated fibula fracture

These guidelines do not establish a standard of care to be followed in every case. It is recognized that each case is different and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare guidelines for each. Accordingly these guidelines should guide care with the understanding that departures from them may be required at times.