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It is well documented that the use of child restraints, specifically child safety seats, can reduce morbidity and mortality in young victims of motor vehicle crashes. Literature review reveals few extremity fractures in properly restrained toddlers. Of 10 restrained infants involved in car crashes admitted to our hospital, 4 had leg fractures. We report 2 cases of bilateral tibial fractures in restrained toddlers in which the usual clinical signs of fracture were minimal or lacking. A high index of suspicion must be maintained in evaluating even properly restrained toddlers in motor vehicle crashes.

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