This x-ray shows a fracture of the proximal tibia. A long leg splint is appropriate for this patient. The typical mechanism for this injury in children is an awkward landing from a trampoline or slide. While accidental injuries in children should always be assessed for risk of abuse, this fracture pattern is not typical for abuse. A “bucket-handle” injury to the epiphyseal-diaphyseal junction and “corner” fractures are red flags for abuse in proximal tibia fractures.

Case presented by Nahum Kovalski, BSc, MDCM, Terem Emergency Medical Centers, Jerusalem, Israel.


4-year-old boy with a blow to his left leg

Nahum Kovalski, BSc, MDCM

Clinical Researcher at TEREM Emergency Services
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