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The correct reading of the x-ray is: greenstick fracture of the distal tibia.
The x-ray was taken and the fracture identified by the urgent care physician. However, the child was placed in a cast splint after referral to hospital, with advice to follow up with an orthopedist.
While the patient could have been casted in the urgent care clinic, tibial fractures in such young children are considered higher risk for abuse; as a matter of policy such cases are typically referred to the hospital so social services staff can get involved immediately.
Clinical Challenge: September, 2007
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