Toddler Fracture

History: 16 month old female refusing to bear weight. 

Radiograph of the right tibia and fibula show a non-displaced oblique fracture through the mid diaphysis of the right tibia (yellow arrow).

This is the appearance of a Toddler fracture. A toddler fracture is a stress type fracture which is typically seen in young children around the age they begin to walk (hence the term “Toddler” fracture). They are nondisplaced spiral tibial shaft fractures. They have been termed childhood accidental spiral tibial (CAST) fractures, in distinction to non-accidental trauma (NAT) fractures, which is on the differential diagnosis for a spiral fracture of the tibia; however, in the case of NAT, usually multiple other healing fractures of different ages are seen, or the fracture is seen in a child who has not begun walking.