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Not just a fracture
  1. Margot Van de Vijver
  1. Department of General Paediatrics, King's College Hospital, London, UK
  1. Correspondence to Dr Margot van de Vijver, mvandevijver{at}

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An 8-month-old girl presented with a reluctance to weight bear on her left leg following a trivial, low impact fall. X-rays showed a fracture of the distal third of the left tibial shaft.

The child's general health and development were normal. There was no suspicion of non-accidental injury from history or enquiry. Investigations excluded nutritional deficiencies and endocrine-metabolic disorders. A skeletal survey showed no other abnormalities. The radiologist raised the possibility of underlying neurofibromatosis type 1 (NF1) in view of the anterolateral bowing of the …

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