Pediatric Endocrinology Expert Forum
Spiral fracture in an infant
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Questions in the Pediatric Endocrinology forum are answered by Dr. Deanna L Aftab Guy. Topics covered include adrenal problems, diabetes insipidus, menstrual irregularities, obesity, parathyroid abnormalities, pituitary abnormalities, puberty concerns, rapid growth, rickets and bone disease, short stature, and thyroid.

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Spiral fracture in an infant

Hello
I adopted a child earlier this year after a long fight. He's biological mother was taking Crack Cocaine for the first 6 months of her pregnancy and was also smoking cigarettes, canabis and drinking alcohol for the full 9 months of the pregnancy. He is fairly small for his age (just turned 2 in October) My problem is earlier this week he was jumping on the bed when he fell and fractured his Femur. He has a spiral fracture and is currantly in traction which will be followed by 8 weeks in a cast. The doctors at the hospital are saying he couldnt possibly have caused such a bad break just by falling on a soft surface and have contacted social workers, assuming its abuse. I would completely agree with this. I too dont believe he couldve had such a bad injury by what is basically a light fall. However as this is the NHS the doctors are coming to this conclusion purely by the one x-ray they took on his admission. Because of his past (he spent the first year of his life in foster care and wasnt fed properly - I was told by the carer that he ate just from her plate) and the start he had in the womb he could have some other problem with his bones that they arent testing for. I am going to take out a loan so I can pay for a private doctor to give him the tests he needs. I've been researcing Hip Dysplasia, Osteogenesis Inperfecta, Endocrine problems and rickets (I read about these on previous forums you had responded to) But can you suggest anything else I should be asking for tests for? He has really thrived with me in the past few months which social workers have agreed with when they have done their regular visits. We've really bonded as a family and I couldnt bare to imagine what could happen to him if he is taken from me particularly at a time when he's sick and needs the love and support of a family. Please help!
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make sure that you have a good pediatrician, do not direct the workup yourself, that is their job, also a social worker who knows you and your family to be your advocate will also help, once your pediatrician talks with the other specialists the care can get directed appropriately so that many appts are not necessary, let the primary care folks start the direction. Hormonal areas to look at that they more than likely know about include vitamin D(rickets), thyroid, calcium disorders not necessarily rickets, genetic abnormalities related to metabolism, these are a few that should not just be addressed with a battery of tests rather looked for in a logical order. I am sure a bunch has been looked into already, do not take out a loan to get answers, work with your doctors that are seeing him already to understand things better
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