In this section
Tibial shaft (diaphyseal) fracture - Emergency Department
Subsequent review appointments
Discharge advice to parents
2 weeks post-immobilisation with x-ray
Removal of backslab at 2-4 weeks post injury
Discharge to GP
To be followed up by GP in 4-6 weeks post injury
Some toddlers may take a number of weeks to start walking let alone walk freely again
Undisplaced tibial shaft fracture
1 week post-immobilisation with x-ray
If stable at 1 week and the cast is appropriate, then at 4-6 weeks post-reduction for change to patella tendon-bearing cast
If there is any concern for instability at the fracture site, then the patient should be seen weekly for the first 3 weeks
It will take 3-4 months from injury before the patient will be back to sports activities
Displaced tibial shaft fracture + / - fibular shaft fracture
1 week for patients who had closed reduction and casting with x-ray
Weekly for the first 3 weeks in patients with unstable fractures
Indications for a consultant orthopaedic surgeon opinion are:
Healed fracture clinically (i.e. pain-free on torsional stress and on palpation at the fracture site) and radiographically with no concerns of alignment (in all planes) or growth disturbance.
Mashru RP, Herman MJ, Pizzutillo PD. Tibial shaft fractures in children and adolescents. J Am Acad Ortho Surg 2005; 13(5): 345-52.
Henrich SD, Mooney JF. Fractures of the shaft of the tibia and fibula. In Rockwood and Wilkins' Fractures in Children, 7th Ed. Beaty JH, Kasser JR (Eds). Lippincott Williams & Wilkins, Philadelphia 2010. p.930-66.