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Broken Shin Bone in a Toddler (Toddler Tibia Fracture)

What is a Toddler's Fracture of the Tibia?
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A toddler’s fracture is a spiral fracture of the tibia that is perfectly or nearly perfectly aligned. A toddler’s fracture occurs in children 1 to 3 years old. It usually happens because of a twisting injury to the leg. The injury or twisting may be minor and go unnoticed. The child usually cries and refuses to bear weight on the injured side.

How is a Toddler's Fracture Diagnosed?

A toddler’s fracture may be diagnosed with X-rays, but often the X-rays are normal. The physician may be highly suspicious that a fracture exists even if an X-ray is normal but the child has tenderness over the lower leg and/or refuses to put weight on the affected side. Usually, there is no swelling or bruising in the area. Even if the X-rays are normal initially, new bone can usually be seen on X-rays that are repeated 2 weeks after the injury as the body heals the fracture.

How is a Toddler's Fracture Treated?

In children’s bones, there is a very thick wrapper surrounding the bone called the periosteum. With toddler’s fractures, the calcified, hard portion of the bone is fractured but the thick periosteum is intact. Because of this, toddler’s fractures are very stable and do not move out of position. This also allows them to heal quickly.

Depending on the size of the child, most of these fractures are treated by placing the child in a walking boot. Boots are nice in that they provide support to the fracture, allow the children to walk, and can be removed for bathing. In some very small children, treatment for this fracture may include a long leg cast because the boots are too small and shorter casts can slide off of small children. With either form of movement restriction, the children can walk on the injured extremity as their pain allows.

What is the Long-Term Outcome of these Fractures?
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Toddler’s fractures usually heal in 3 to 4 weeks. The child can resume all usual activities afterward. Toddler’s fractures do not affect the child’s growth plate, so there is no risk for problems with growth or deformity of the tibia in the future. These fractures will not cause any long-term limitations on physical activities or sports.