SplintER Series: One Big Bounce
Figure 1. AP and Lateral x-rays of the right knee. Case courtesy of Dr Andrew Dixon, Radiopaedia.org, rID: 16139
Transverse fracture of the proximal tibial metaphysis, otherwise known as trampoline fracture (Figure 2).
Figure 2. AP and Lateral x-rays. Note the Transverse fracture of the proximal tibial metaphysis, otherwise known as trampoline fracture (green arrows). Case courtesy of Dr Andrew Dixon, Radiopaedia.org, rID: 16139, annotations by author
This fracture typically occurs when a child is bounced by a larger individual on a trampoline or bouncy house (Figure 3). As the larger individual lands, the force of the springing surface travels through the child’s leg, creating an impact fracture [1].
- PEARL: This fracture typically occurs in patients between the ages of 2-5 due to an immature skeleton and lack of coordination [1].
Figure 3. Illustration by Tabitha Ford, MD
This fracture pattern is typically minimally displaced, and patients should be placed in a long leg splint and made non weight bearing [1]. They can follow up with either orthopedics or sports medicine as an outpatient in 1-2 weeks.
- PEARL: If there is significant displacement, consult orthopedics and keep compartment syndrome in mind as tibial fractures are a risk factor.
Resources and References
Check out ALiEM’s Paucis Verbis cards to brush up on other can’t miss orthopedic injuries, and SplintER Series for more pediatric cases.
- G.A. Smith, B.J. Shields. Trampoline related injuries to children. Arch Ped Adoles Med, 152 (1998), pp. 694-699
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