Tibial fracture

Last updated: March 2, 2022

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Tibial fractures are the most common type of long bone fractures. They are usually caused by direct trauma and may occur proximally (tibial plateau fracture), at the shaft, or distally. The fracture may solely involve the tibia or the fibula, or it may involve both. As only a small amount of tissue covers the bone structures, there is a higher risk of open fracture, neurovascular injury, compartment syndrome, and wound infection. Depending on the location and stability of the fracture, treatment may involve casting, intramedullary nailing, open reduction and internal fixation, or external fixation.

Toddler fracture [1][2]

  • Definition: a nondisplaced fracture of the distal tibial shaft, usually following acute trauma (e.g., falling, tripping), causing rotation of the body around a fixed foot
  • Epidemiology: commonly seen in children between nine months and three years of age [2]
  • Etiology: trauma (e.g., low energy fall from a chair or table, tripping while running)
  • Clinical features
    • Irritability
    • Abnormal gait (limping or inability to bear weight)
    • Localized tenderness over the distal tibial shaft
  • Diagnostics
    • Often goes undetected due to subtle clinical and radiographic findings
    • Imaging
  • Treatment: immobilization with a long cast, controlled ankle movement walker boot, short cast, or splint [3]

See “General principles of fractures.”

See “General principles of fractures.”

We list the most important complications. The selection is not exhaustive.

  1. Naranje S, Kelly DM, Sawyer JR. A Systematic Approach to the Evaluation of a Limping Child.. Am Fam Physician. 2015; 92 (10): p.908-16.
  2. Yiqiao Wang, Meagan Doyle, Kevin Smit, Terry Varshney, Sasha Carsen. The Toddler's Fracture. Pediatr Emerg Care. 2021; 38 (1): p.36-39. doi: 10.1097/pec.0000000000002600 . | Open in Read by QxMD
  3. Bauer JM, Lovejoy SA. Toddler's Fractures: Time to Weight-bear With Regard to Immobilization Type and Radiographic Monitoring.. J Pediatr Orthop. 2019; 39 (6): p.314-317. doi: 10.1097/BPO.0000000000000948 . | Open in Read by QxMD
  4. Mehin R, O’Brien P, Broekhuyse H, Blachut P, Guy P. Endstage arthritis following tibia plateau fractures: average 10-year follow-up. Canadian Journal of Surgery. 2012; 55 (2): p.7-94. doi: 10.1503/cjs.003111 . | Open in Read by QxMD

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