Iatrogenic bilateral tibial fractures after intraosseous infusion attempts in a 3-month-old infant.
A 3-month-old girl presented to the emergency department with a clinical picture compatible with sepsis. When peripheral IV cannulation could not be attained, intraosseous (IO) access was attempted unsuccessfully in both tibias as well as in the right femur. The child was subsequently treated for S pneumoniae meningitis. Three days after discharge and 14 days after initial presentation, the family noticed swelling of the child's right leg. Radiographs revealed healing fractures of both proximal tibias. This case represents a previously unreported complication of intraosseous infusions and underscores the need for the use of proper technique and equipment.
La Fleche
F R
FR
Emergency Medicine Residency Program, Eastern Virginia Graduate School of Medicine, Norfolk.
Slepin
M J
MJ
Vargas
J
J
Milzman
D P
DP
D001842:Bone and Bones; D004333:Drug Administration Routes; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D007223:Infant; D009339:Needles; D011859:Radiography; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000209:etiology*