Toddler Tibia Fracture
Clinical Pathways promote evidence-based, safe, and high-value care for patients by providing clinical recommendations and standard processes. They are developed by multidisciplinary committees of subject matter experts, informed by a methodical review of available evidence and consensus among committee members.
Clinical Pathways:
- Toddler Tibia Fracture Algorithm
- Skin Breakdown Under Cast Algorithm
- Toddler Tibia Fracture Synopsis (provides care standards employed for this clinical pathway)
Additional tools associated with this Clinical Pathway:
Inclusion and exclusion criteria
Inclusion:
- Patients aged 1 to 4 years.
- Stable tibial shaft or distal tibia fracture, defined as:
- No cortical displacement.
- No fracture shortening.
- No angulation.
- No malrotation.
- Intact fibula.
- Can be spiral or buckle fracture pattern.
Exclusion:
- Patients with multisystem trauma.
- High energy mechanism.
- Infection.
- Neoplasm.
- Non-accidental trauma.
- Non-ambulatory.
- Multiple fractures.
- Metabolic bone disease.
- Any amount of cortical displacement.
- Any amount of fracture shortening.
- Any amount of angulation.
- Reduction required.
- Associated fibula fracture.
Committee members involved in the revision:
- Caleb Grote, MD, PhD | Orthopaedic Surgery | Committee Chair
- Emily Trester, MSN, RN-BC, CPNP-CP | Orthopaedic Surgery | Committee Member
- B. Haney, BSN, RN, CWCN, WTA-C | Wound Care | Committee Member
Evidence Based Practice
- Todd Glenski, MD, MSHA, FASA | Anesthesiology & Evidence Based Practice
- Jarrod Dusin, PhD, RD, LD, CPHQ | Evidence Based Practice
Publication dates:
- Finalized date: July 2025
- Next expected revision date: July 2028
If you have any questions regarding this content or identify a broken link, please email evidencebasedpractice@cmh.edu.
These pathways do not establish a standard of care to be followed in every case. It is recognized that each case is different, and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare a pathway for each. Accordingly, these pathways should guide care with the understanding that departures from them may be required at times.