EXPANDING THE CONCEPT OF THE TODDLERS FRACTURE

Fracture of the tibia is a well-known, often occult cause of limping a nd leg pain in young children, This fracture is typically a hairline, oblique fracture of the shaft of the tibia, and in some cases the frac ture can be so subtle that bone scintigraphy or follow-up radiography may be required for its detection. In addition, a variety of other fra ctures that are less well known and just as difficult to detect can oc cur in the tibia and the foot in young children, These fractures inclu de plastic bowing and buckle-type fractures, especially of the fibula; impaction, compression, or stress (fatigue) fractures of the tibia an d fibula; and fractures of the metatarsal and tarsal bones, All of the se fractures can be remarkably similar to the nondisplaced spiral tibi al fracture in their clinical appearance and should be included under the rubric of ''toddler's fracture.''