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Forum Name: Bone trauma and fractures

Question: 4 year old fractured tibia


 joecoz - Mon Jun 14, 2010 1:47 pm

my 4 year old fractured her tibia (spiral fracture) 3 and a half weeks ago. after our 2nd visit back to the hospital today the fracture is in line and healing well and was told she could put light pressure on it. we were initially told it would be 4-6 week but we fly out to get married in 17 days and were today told to come back in three week. as we are away for 2 week the doctor told us to come back once we get back - this will mean the cast will be on for over 8 week and we were after a second opinion to whether 6 week is normally sufficiant.
 Dr.M.Aroon kamath - Fri Jun 18, 2010 12:55 am

User avatar Hi,
As you have not provided details of the fracture(exact location,status of the fibula,presence or absence of displacement etc),it may not be possible to be very specific about the management. However, i will try to offer some some general information regarding these fractures.

There are many types of tibial fractures (some due to accidental trauma and others due to non-accidental trauma) and spiral fractures are one among them. Most occur in toddlers.

A typical toddler's fracture is a non-displaced oblique fracture of the distal tibia in children (9 months to 3 years of age).These fractures typically occur in the lower third of the tibia.Spiral fractures also occur in older children. CAST (Childhood Accidental Spiral Tibial) fracture, which is one such, is an isolated spiral fracture of tibia.The fracture line usually begins more proximally at the midshaft and extends down to the distal tibia. The approximate age range is 2 - 6 years.

A twisting force is the underlying mechanism in spiral fractures.Twisting or rotational force through the tibia while the ankle and foot are fixed, results in these fractures.

A child with a toddler’s fracture will be usually treated in a long leg cast bent at the knee joint for approximately three to four weeks. An additional 2 weeks of immobilization in a short leg walking cast is generally prescribed in most cases.

Healing is confirmed radiologically and by clinical means. As your child is slighty older than the typical toddler, decision for removing the cast should be ideally left to your orthopedic surgeon who is best placed to assess the fracture healing.

Best wishes!

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