toddler fractureA subtle, nondisplaced spiral fracture of the distal third of the tibia, caused by a fall with twisting torque on the lower leg. It is the most common fracture in pre-school-aged children who present with a limp, typically at 1–3 years when they begin weight bearing whilst learning to walk; though it may occur up to age 6.
Reluctance and refusal to walk or put weight on affected leg, which reflects a history of trauma.
Non-traumatic causes of limp in a child of this age, such as hip dysplasia, septic arthritis, osteomyelitis, discitis and neoplasia should be excluded.
Long-leg or below-the-knee cast for 3–6 weeks.