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Does immobilisation improve outcomes in children with a toddler’s fracture?
  1. Riki Houlden
  1. Correspondence to Riki Houlden, School of Clinical Medicine, University of Cambridge, Cambridge CB1 3HP, UK; rh571{at}cam.ac.uk

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Scenario

A 2-year-old boy presents to the emergency department with inability to weight bear on the right leg following injury on a slide witnessed by the mother. A non-displaced spiral tibial fracture is visible on plain radiography, and the patient is diagnosed with a toddler’s fracture. A colleague comments that immobilisation is the typical management but some elect to treat conservatively. You wonder what the effect of immobilisation is on patient outcomes.

Clinical question

In children with a toddler’s fracture (patient), does immobilisation (intervention) compared with no immobilisation (comparison) influence recovery time or affect the incidence of complications (outcomes)?

Search

Searches were all performed on 7 March 2018.

Cochrane Library

Search: ((toddler’s AND fracture) OR (child* AND accident* AND spiral AND tibia* AND fracture)) AND (immobil* OR cast* OR brac* OR splint* OR boot* OR controlled ankle …

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