Let’s go through what a toddler’s fracture is and what you can expect over the next few weeks.

 

The lower leg has two bones. The tibia is the larger one — it’s the main weightbearing bone and carries most of the body’s weight. The fibula sits on the outside of the leg and is smaller, playing a lesser role in weightbearing.

 

A toddler’s fracture is a small, spiral-shaped break in the shaft of the tibia. It typically happens in younger children, usually between one and four years old. It often occurs after a fall or knock to the shin, and the child may stop walking or refuse to put weight on the leg. In some cases, the initial X-ray doesn’t clearly show the fracture — only around half of these injuries are obvious at first. If needed, we can repeat the X-ray after a week or so to confirm the diagnosis as healing begins.

 

Even though these fractures are usually very stable and well-aligned, we still use a cast to support the leg in the early stages and make things more comfortable.

 

Once a toddler’s fracture is suspected or confirmed, our goal is to keep the child comfortable while the bone starts healing. In the emergency department, the leg is usually put in an above-knee cast, and your child should avoid putting weight on it for now. Most children will naturally avoid walking for the first week or two because of pain.

 

You’ll usually be given a follow-up appointment in the fracture clinic about a week later. If we weren’t sure about the diagnosis at first, we might repeat the X-ray at that stage to confirm whether or not a fracture is present.

 

If we’ve confirmed a toddler’s fracture, the cast can usually be swapped to a soft removable cast or a walking boot at that first clinic visit. Your child can begin walking again as soon as they feel ready. Once they’re comfortable walking, the boot or cast can usually be stopped after two to three weeks.

 

These injuries nearly always heal fully without long-term problems. Because the fracture is stable and well-aligned, there’s no need for surgery. The main thing to be aware of is that the child shouldn’t put too much weight on the leg too early — this could cause discomfort or disrupt the healing.

 

Swelling tends to peak in the first few days. Keeping the leg elevated above heart level can help reduce pain and swelling. If the cast starts to feel too tight, or you notice numbness, tingling, or any colour changes in the toes, please return to the emergency department so the cast can be checked or adjusted.

 

As the bone heals, you may notice a small lump forming along the front of the shin. This is a normal part of the healing process and will gradually smooth out over the next few months.

 

In the early days, your child will need to rest the leg and may be quite reluctant to move it. But with the support of the cast, pain usually improves quickly. By around three to four weeks after the injury, most children are keen to start walking again. It’s normal to see some limping or hesitation at first, but confidence builds quickly.

 

If everything is going well, your child may be discharged from clinic at the one- or two-week follow-up, with advice on when to remove the boot or splint at home.

 

Most children are back to running, jumping, and playing normally within six to eight weeks of the original injury. We don’t usually need to involve physiotherapy — children tend to recover full function on their own just through daily activity.