Tibial Fracture in Children

Tibial Fracture in Children – How to identify in my child

A tibial fracture is a break in the larger bone in the lower leg (tibia). This bone is also called the shin bone.

What are the causes?

This condition is caused by an injury to the leg, such as an injury from:

  • A fall.
  • Contact sports.
  • A motor vehicle accident.

What increases the risk?

Your child may be more likely to develop this condition if he or she:

  • Plays a sport.
  • Does activities that involve:
    • Jumping.
    • Doing the same movements over and over (repetitive stress), such as long-distance running.

What are the signs or symptoms?

Symptoms of this condition include:

  • Pain.
  • Swelling.
  • Bruising.
  • Inability to put weight on the leg or use the leg to walk.
  • The leg having an abnormal shape (deformity).
  • Numbness or a pins-and-needles feeling in the feet. This may indicate a nerve injury.

How is this diagnosed?

This condition may be diagnosed based on:

  • Your child’s symptoms and medical history.
  • A physical exam.

Your child may also have other tests such as:

  • X-rays. In toddlers and infants, an X-ray may not show the fracture. X-rays will be repeated days or weeks later.
  • A CT scan.
  • MRI.

How is this treated?

Treatment for this condition includes:

  • Wearing a cast or splint on the lower leg to keep it from moving while it heals (immobilization). Younger children may have a cast or splint that covers their entire leg. Your child will wear the cast or splint until his or her health care provider thinks the bone has healed enough.
  • Using crutches to avoid putting weight on the leg until your child’s health care provider thinks the bone has healed enough.
  • Doing physical therapy exercises to regain movement (range of motion) in the knee. Your child will start physical therapy after his or her cast or splint is removed.

If the injury caused parts of the bone to move out of place, your child’s health care provider may reposition the bone parts before putting on the cast or splint. If your child has a severe fracture, he or she may need surgery to place plates or screws into the bone to hold it in place.

Follow these instructions at home:

If your child has a splint:

  • Have your child wear the splint as told by your child’s health care provider. Remove it only as told by your child’s health care provider.
  • Loosen the splint if your child’s toes tingle, become numb, or turn cold and blue.
  • Keep the splint clean and dry.

If your child has a cast:

  • Do not allow your child to stick anything inside the cast to scratch the skin. Doing that increases the risk of infection.
  • Check the skin around the cast every day. Tell your child’s health care provider if you have any concerns.
  • You may put lotion on dry skin around the edges of the cast. Do not put lotion on the skin underneath the cast.
  • Keep the cast clean and dry.

Bathing

  • Do not have your child take baths, swim, or use a hot tub until his or her health care provider approves. Ask your child’s health care provider if your child can take showers. Your child may only be allowed to have sponge baths.
  • If the splint or cast is not waterproof:
    • Do not let it get wet.
    • Cover it with a watertight covering when your child takes a bath or a shower.

Managing pain, stiffness, and swelling

  • If directed, put ice on the injured area:
    • If your child has a removable splint, remove it as told by your child’s health care provider.
    • Put ice in a plastic bag.
    • Place a towel between your child’s skin and the bag, or between the cast and the bag.
    • Leave the ice on for 20 minutes, 2–3 times a day.
  • Have your child:
    • Move his or her toes often to avoid stiffness and to lessen swelling.
    • Raise (elevate) his or her lower leg above the level of the heart while sitting or lying down.

Activity

  • Do not allow your child to use the leg to support his or her body weight until your child’s health care provider says that it is okay to do so. Your child should follow weight-bearing restrictions and use crutches as directed.
  • Ask your child’s health care provider what activities are safe for your child during recovery. Have your child avoid activities as told by your child’s health care provider.
  • Have your child do physical therapy exercises as directed.

Driving

  • If your child is old enough to drive:
    • Do not allow your child to drive until his or her health care provider approves.
    • Donot let your childdrive or use heavy machinery while he or she is taking prescription pain medicine.

General instructions

  • Do not allow your child to put pressure on any part of the cast or splint until it is fully hardened. This may take several hours.
  • Do not allow your child to use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. These can delay bone healing.
  • Give over-the-counter and prescription medicines only as told by your child’s health care provider.
  • Keep all follow-up visits as told by your child’s health care provider. This is important.

Contact a health care provider if your child has:

  • Pain that gets worse or does not get better with medicine.
  • Redness or swelling that gets worse.
  • Numbness or tingling in the toes or foot.

Get help right away if:

  • Your child’s foot or toes feel cold or turn blue, even after loosening the splint.
  • Your child has severe pain.

Summary

  • A tibial fracture is a break in the larger bone in the lower leg (tibia).
  • These fractures usually result from a car accident or from sports.
  • Treatment usually involves wearing a cast or splint and not putting weight on the leg until it is healed. Surgery is sometimes needed.
  • Make sure you understand and follow all home care instructions from your child’s health care provider.
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