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Proximal tibial fractures in children

Jennifer Chapman, MD
Joanna Cohen, MD
Section Editor
Richard G Bachur, MD
Deputy Editor
James F Wiley, II, MD, MPH


The evaluation and management of proximal tibial fractures in children is reviewed here. Other pediatric fractures of the tibia or fibula are discussed separately. (See "Tibial and fibular shaft fractures in children" and "Stress fractures of the tibia and fibula" and "Ankle fractures in children".)


Proximal tibial fractures are infrequent in children relative to diaphyseal and distal tibial fractures. In toddlers, metaphyseal corner or bucket handle fractures are highly associated with child abuse. (See "Orthopedic aspects of child abuse".)

Other patterns of injury correspond to the age of the child and the type of force [1]:

Young children (three to nine years of age) are at risk for greenstick or complete metaphyseal fractures when valgus or varus stress is applied. Jumping on a trampoline with other children is a common mechanism.

Older children (10 to 12 years of age) are at risk for tibial spine avulsion from hyperextension and rotation injury (eg, most commonly a fall from a bicycle or motorbike).

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Literature review current through: Nov 2017. | This topic last updated: May 30, 2017.
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