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Joseph Junewick, MD FACR
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Toddler Fracture

Case Detail

Anatomy: Musculoskeletal
Joseph Junewick, MD FACR
Diagnostic Category: Trauma
Created: over 10 years ago
Updated: over 10 years ago
Tags: PEDS
Modality/Study Types: CR
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16 month old female refusing to bear weight.

Case Images


Toddler Fracture


CR – Buckled cortex of the proximal tibial metaphysis.


The proximal tibia buckle fracture is a variant of the “toddler” fracture. Application of an anterior force to the hyperextended knee results in a transverse fracture of the proximal tibia. Often there is only buckling of the anterior cortex related to compression but scooping of the bone subjacent to the anterior tuberosity and anterior tilting of the epiphysis may also be seen. With greater force, diastatic fracture may also be seen posteriorly related to distraction. Clinically, this injury may be suspected if pain is evoked with hyperextension.


Swichuk LE, John SD, Tschoepe EJ. Upper tibial hyperextension fractures in infants: another occult toddler’s fracture. Pediatr Radiol (1999); 29:6-9.

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