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Child Abuse

Spiral Fracture From Fall

01/30/2007

Question:

In theory if a child who was lactose intolerant as a baby, now at the age of 2 1/2 years was running, got her right foot caught with toes facing to the right and heel to left under a metal door strip locking her right foot into a fixed position, followed by her left leg slamming into her right leg with her upper body then bouncing of the door jam causing her to spin ever further to the right at nearly a 180 degree angle, cause a spiral fracture of the lower tibia?

Answer:

Spiral fractures can occur accidentally, especially if the child is old enough to walk, such as the 2 ½ year old child you ask about. Some spiral fractures are also called Toddler's fractures.  These commonly occur in children ages 1- 7 years old. The mechanism of injury is often rotational in nature such as tripping or twisting of the ankle.

Spiral fractures can also be caused by an abusive incident. Child abuse is considered in a child who is not yet walking or when the history of injury seems to be inconsistent with an accidental cause.

Submitted by Megan McGraw, MD

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Response by:

Robert Shapiro, MD
Professor of Clinical Pediatrics
College of Medicine
University of Cincinnati