• Reference Number: HEY1237/2021
• Departments: Emergency Department, Paediatrics
• Last Updated: 14 May 2021

Introduction

This leaflet provides you with information about a toddler’s fracture, what it is and how it is treated. It also explains what to expect over the next few weeks and provides advice on what you can do to help your child.

What is a toddler’s fracture?

The lower leg has two bones; the larger bone is called the tibia and the smaller bone is called the fibula. A toddler’s fracture is when the tibia has a spiral fracture – a fracture is when there is a break in the bone.

Toddler’s fractures are common in ambulatory infants and young children. It is caused by a twisting injury when a child stumbles or falls. Toddler’s fractures heal really well and cause no lasting problems for your child.

Diagnosing a toddler’s fracture

A medical professional may suspect your child has a toddler’s fracture if they are not using their leg as they normally would. This might mean they are refusing to walk, or they are limping. An X-ray is taken which can be used to diagnose a toddler’s fracture.

In some cases, a child will be managed and treated as if they have a toddler’s fracture, even if the X-ray looks normal. This is because sometimes the fracture can be too small to be seen on an X-ray.

Treatment of a toddler’s fracture

A plaster cast may be offered to help treat a toddler’s fracture. This will help keep the leg in one position which can help reduce the discomfort felt by your child. The cast usually goes from the foot up to the top of the leg.

Your child can put weight on their leg and use their leg when wearing the cast when they feel able to do so. The cast will need to stay on for 3 weeks and then you can remove the cast at home (someone will show you how to do this before you leave the department).

If there is no requirement for comfort a cast will not be applied as the fracture will heal by itself. 

What to expect

During the first week following a toddler’s fracture injury, your child may be reluctant to walk or use their leg and this is normal. They may experience some discomfort, but this should not be enough to stop them wanting to play in ways that do not involve using their leg.

As the fracture heals, your child will start to use their leg more and be able to weight bear and walk.  If your child has a cast, this can make it harder for your child to move as they normally would. When the cast is removed, it is normal for a child to be initially hesitant to use their leg, usually for the first few hours but occasionally may be longer – a day or so. This should improve and they should be able to use and put weight on their leg. When your child begins to weight bear on the injured leg and walk it may look differently to how they used to, but this should get back to normal over the next few weeks.

Virtual Fracture Clinic

You will have an appointment at the virtual fracture clinic with someone from the Orthopaedic team (bone and fracture specialists), who will review the X-ray of your child’s leg taken when you visited the Emergency Department. You do not need to come to hospital for this appointment, as a member of the Orthopaedic Team will contact you by telephone. During this telephone call, you will be able to discuss your child’s fracture in more detail, and you will be advised whether any further X-ray images or treatment is needed.

As this appointment is over the phone, please make sure the contact details the hospital has for you are correct before you leave the Emergency Department.

What to do at home

Paracetamol and ibuprofen can help manage your child’s discomfort at home. These should be given regularly in the first 48 hours, following the instructions given with the medication. The pain can last around a week, so you should continue to give pain relief medication as required to help manage this.

Problems to be aware of:

If you notice any of the following, you should come back to the Emergency Department:

• Your child is in pain that is not getting better with pain relief medication.
• Your child has a new pain, or their pain is getting worse.
• Your child’s injured leg, or their foot or toes on the injured side look swollen.
• Your child says that they have a tingling feeling in their injured leg, or their foot or toes on the injured side.
• The plaster cast looks or feels too tight.