Toddler's fracture: an updated guide on evaluation and management.

J Pediatr Orthop B · Mar 01 2025 · Review

Noe MC, Jarka DE, Sinclair MK, Grote CW

Department of Orthopaedic Surgery, Children's Mercy Kansas City, Kansas City, Missouri

Pediatric Orthopaedics Orthopaedic Trauma

SUMMARY — THE REDUCTIONToddler's fractures rarely displace or fail to heal, and removable walking boots or no immobilization cause fewer skin complications than traditional casts or splints, though practice still varies widely.
Abstract, as published

Toddler's fractures are commonly encountered in pediatric healthcare. These injuries are associated with little to no risk of fracture displacement or failure to heal, regardless of treatment modality. The standard treatment for these injuries has historically been several weeks of weightbearing restriction and immobilization in a circumferential cast or posterior splint. Over the last decade, numerous reports comparing clinical outcomes and iatrogenic complication rates between treatment modalities have emerged, revealing a concerning trend of higher rates of skin breakdown in patients treated with traditional management compared to those treated with removable walking boot immobilization or no immobilization. Current management practices for toddler's fractures vary widely with respect to both initial and follow-up care, reflecting a need for additional guidance on this topic. This review provides an updated, evidence-based review of evaluation and management strategies for the toddler's fracture.

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