Toddler Fracture: Causes, Symptoms, Diagnosis And Treatment
Your child can't be vocal, so you must know the signs of fracture if it happens in your absence.
Specialty: Pediatrics, Asthma and AllergyExperience: 19 yearsDr. Garima Garg Seth is a well-known pediatrician in Gurgaon, having more than 19 years of experience in this field. She has completed her education from topmost organizations in India, including AIIMS, New Delhi; Sir Ganga Ram Hospital, New Delhi; and CMC Vellore.
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In This Article
In infants and toddlers, a fracture of the tibia bone, the small bone in the lower leg, is known as toddler’s fracture. It is also known as childhood accidental spiral tibial fracture (CAST fracture) and is a common childhood fracture. It could be caused by a twist in the legs while tripping, falling, or standing. After this fracture, your toddler may refuse to walk or may walk with difficulty.
Although toddler’s fracture usually occurs in early childhood (commonly seen in nine-month-old infants to three-year-old toddlers), it may the hinder bone development processes or other activities of a toddler.
Learn more about the signs, common causes, diagnosis, and treatment options for toddler’s fracture.
Common Causes Of Toddler’s Fracture
The causes of toddler’s fracture may not always be obvious. Any injury or fall that exerts pressure on the tibia may increase the risk. Common causes may include (1):
- Leg twisting while running or walking
- Foot twist while sliding down on slides, especially while sitting on someone’s lap
These injuries can cause shear stress, which causes a force to deform the bone. However, displacement of bone is not seen, and the periosteum (outer layer of the bone) remains intact.
Signs And Symptoms Of Toddler’s Fracture
The following signs and symptoms are seen in a toddler’s fracture (1).
- Pain and swelling over shinbone (tibia)
- Ankle or foot swelling
- Limping all time or sometimes
- Refuses to bear weight on the leg
- Pain on dorsiflexion (bending foot upwards)
- Warmness over the fractured area
Tenderness at the fracture site is common but is at times hard to elicit in young children. Deformation of the leg and bruises over the fractured area is not seen in the toddler’s fracture. Some toddlers may limp but may not remember any injuries. Therefore, you may consider consulting a pediatrician if the toddler limps, irrespective of any knowledge of an injury.
Diagnosis Of Toddler’s Fracture
Doctors may do a physical examination and ask about how the injury happened. X-ray of the lower leg is done to look for a toddler’s fracture. If there is no obvious sign of fracture on X-ray, the toddler may still be treated for fracture considering it as suspected toddler’s fracture case provided there are no other issues.
Anterior, posterior, and lateral X-ray views of leg bones are taken to look for fracture lines. A second X-ray scan is done after 10 to 15 days to confirm the diagnosis in some cases since fracture lines may be visible at this time. Sonographic (ultrasound) imaging is also done in some cases to look for a toddler’s fracture (2).
Treatment For Toddler’s Fracture
Leg immobilization with CAM boots or splints is recommended for confirmed and suspected cases of toddler’s fracture. However, a long leg-cast is not often done if the pediatric orthopedic doctor thinks that the child requires further examination after one or two weeks. Parents are also advised to keep the cast or CAM boots clean and dry.
Three to four weeks of immobilization is recommended for a toddler’s fracture (3). Some children may limp or walk as if they have a stiff leg even after removing the cast or splint. You may notice they walk with their toes turned out. This is normal and gets better with time, and does not require physical therapy.
When To Consult A Doctor?
Seek pediatric care if the toddler has symptoms of a toddler’s fracture. You may also contact or visit the doctor if toddlers develop any of the following signs and symptoms after initial treatment.
- Toe numbness or tingling
- Bluish-purple color of toes
- Cold toes
- Swelling and pain
- Fever
Consider raising your toddler’s leg above heart level for a few seconds, and if the toes do not become pink within three seconds, you may contact the doctor.
Prognosis Of Toddler’s Fracture
The prognosis of toddler’s fracture is good regardless of treatment strategies. Toddler’s fracture may heal in three to four weeks, and the toddler can resume normal activities afterward. Growth plates are not affected in this fracture, and there is no risk of bone deformity or growth problems (4).
Studies have not noted common fracture complications such as nonunion, refracture, or displacement in toddler’s fractures. Skin breakdown from casting or splinting is rarely seen. Toddler’s fractures do not limit future sports or physical activities (5).
Frequently Asked Questions
1. Can a toddler walk with a toddler fracture?
If diagnosed or suspected, a toddler’s fracture may be treated with no immobilization, a splint, or a walking boot. However, they should not walk if the fracture has been immobilized using a splint (1).
2. Do toddlers’ bones break easily?
Bones in children are softer than in adults and usually buckle or bend rather than a complete fracture. Additionally, fractures heal faster in young children (6).
A toddler fracture, or fracture of the tibia in the leg, is common. It usually occurs in the initial few years when they learn to walk. The child may not remember where they fell; therefore, if your toddler limps, you must have them examined by a doctor. Medical history, a physical examination, and an x-ray may be used to diagnose a toddler’s fracture. CAM boots, splints, and immobilization should be followed as per the doctor’s guidelines. In most cases, a toddler’s fracture heals completely and uneventfully, and long-term physiotherapy is not required.
Key Pointers
- Some signs of fracture in toddlers are limping, swelling on the ankle, shinbone, or foot, and pain.
- Treatment may involve leg immobilization with CAM boots or splints. However, it is based on the severity of the condition.
- Ensure to consult a doctor if you observe toe numbness, swelling, pain, and fever in your little one.
References
2. Toddler Fracture; Radiopedia
3. Management of Toddler’s Fracture; U.S. National Library of Medicine
4. Broken Shin Bone in a Toddler (Toddler Tibia Fracture); Texas Children’s Hospital
5. An Updated Approach to Toddler Fractures; The Journal of Urgent Care Medicine
6. Pediatric Broken Bones; Children’s National Hospital
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Read full bio of Dr. Garima Garg Seth
