• Reference Number: HEY1237/2025
• Departments: Emergency Department, Paediatrics
• Last Updated: 31 May 2025

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.

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats your child, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to your child. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your child’s condition, the alternatives available for your child, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

• you must be able to give your consent
• you must be given enough information to enable you to make a decision
• you must be acting under your own free will and not under the strong influence of another person

Information about your child

We collect and use your child’s information to provide your child with care and treatment. As part of your child’s care, information about your child will be shared between members of a healthcare team, some of whom you may not meet. Your child’s information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide your child with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your child’s doctor, or the person caring for your child.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about your child. For further information visit the following page: Confidential Information about You.

If you need information about your child’s (or a child you care for) health and wellbeing and their care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.