Skip to main content

Leg Fractures

Leg fractures in children can involve the femur (thigh bone) or tibia (shin bone). Treatment depends on the child's age, the location of the fracture, and how well the bones are aligned. Many leg fractures can be treated without surgery, although some more severe injuries may require surgical intervention. 

Femur (Thigh Bone) Fractures 

The femur is the largest and strongest bone in the body and forms part of both the hip and knee joints. Femur fractures usually result from high-energy injuries, such as motor vehicle accidents, contact sports, or falls from a significant height. 

Important considerations: 

  • Treatment depends on your child's age, fracture location, and fracture alignment. 
  • In infants and toddlers who are not yet walking, a femur fracture requires careful evaluation. 
  • Some femur fractures may heal with slight shortening or overgrowth of the leg. 
  • Long-term monitoring of leg length may be recommended. 

Types of Femur Fractures 

Hip fractures (upper femur) 

  • Occur near the hip joint. 
  • Infants and toddlers may be treated with a harness or brace. 
  • Older children and adolescents may require:  
    • A hip spica cast, or 
    • Surgery, depending on the fracture type and severity. 

Femoral shaft fractures (middle of the thigh bone) 

  • Occur in the midportion of the femur. 
  • Often treated with a hip spica cast, with or without a closed reduction (repositioning the bone without surgery). 
  • Some fractures require surgery using:  
    • Flexible nails 
    • Rigid nails 
    • Plates and screws 
  • Older children and more severe fractures are more likely to require surgery. 

Distal femur fractures (near the knee) 

  • Occur just above the knee. 
  • Frequently involve the growth plate. 
  • Often treated with a long-leg cast. 
  • Growth plate involvement may require long-term follow-up to monitor for growth disturbances. 

Tibia (Shin Bone) Fractures 

The tibia is the larger of the two lower leg bones and helps form both the knee and ankle joints. Tibia fractures can occur from direct injuries, falls, or twisting incidents. 

Treatment depends on: 

  • Your child's age. 
  • Fracture location. 
  • Bone alignment. 
  • Whether the growth plate is involved. 

Types of Tibia Fractures 

Proximal tibia fractures (near the knee) 

  • Most common in young children. 
  • Often called trampoline fractures because they frequently occur when multiple people jump on a trampoline together. 
  • Typically treated with a long-leg cast for 3-4 weeks. 
  • Children can often walk in the cast. 
  • Additional follow-up may be needed if the growth plate is involved. 

Tibial shaft fractures (middle of the shin bone) 

  • Occur in the midportion of the tibia. 
  • Can result from falls, sports injuries, or direct blows to the leg. 
  • Includes toddler's fractures, which can occur after a minor twisting injury. 
  • Many heal without surgery. 
  • Treatment may include:  
    • A cast or walking boot. 
    • Closed reduction before casting if alignment needs adjustment. 
  • Weekly X-rays may be recommended early in treatment to monitor alignment. 
  • Weight bearing is usually restricted initially, then gradually allowed as healing progresses. 
  • Return to normal activities may take 2-3 months or longer. 

Distal tibia fractures (near the ankle) 

  • Occur in the lower part of the shin bone near the ankle. 
  • Often involve the growth plate. 
  • Additional imaging, such as a CT scan, may be needed. 
  • If alignment is acceptable, treatment may include:  
    • A short-leg cast, or 
    • A walking boot. 
  • Walking is usually delayed for several weeks. 
  • Growth plate injuries may require follow-up X-rays to ensure normal bone growth. 
Fracture Care Menu