Toddler's Fracture and a Walking Boot: How to Care for Your Child

A toddler's fracture is a break in the shinbone (tibia). A walking boot — also called a CAM (controlled ankle movement) walker — is used to support the broken bone and help with pain while the break heals. With proper care, your child will feel better in a few weeks.

• Help your child wear the boot as directed by the health care provider.

• Follow the health care provider's instructions about whether your child should walk while wearing the boot or while not wearing the boot.

• You can give medicine for pain if your health care provider says it's OK. Use these medicines exactly as directed:

  • acetaminophen (Tylenol^® or a store brand)

  • OR

  • ibuprofen (Advil^®, Motrin^® or a store brand)

• Encourage your child to wiggle the toes to keep blood circulating normally.

• Follow up with your pediatrician or an orthopedic doctor (bone specialist) as directed.

Boot Care:

• Follow the directions for taking the boot off and putting it back on: 

  • Check that the heel fits snugly in the back of the boot.

  • Make sure the toes do not hang over the front edge of the boot.

• If the boot feels too tight, adjust the straps. DO NOT bend or adjust the frame.

• To clean the boot:

  • Wipe the frame with a soft cloth and gentle soap, if needed. Let air dry.

  • Hand wash the liner with mild soap and water. Let air dry. Do not put the liner in a washing machine or clothes dryer.

• The boot has damage to the frame or the liner.

• The skin under the boot is rubbed or raw.

• Your child's pain isn't helped by pain medicine. 

• Your child develops a fever.

Your child can't move the toes, or the toes turn white, purple, or blue.

How does a toddler's fracture happen? A toddler's fracture is a break in the tibia that can happen when a child trips or falls or twists their foot too far out. This can put a strain on the bones of young kids and cause a crack in the bone. It's called a "toddler's fracture" because young children are most likely to get this type of injury.

How is a toddler's fracture diagnosed? The health care provider will ask about how the injury happened and check the injured leg. If a toddler's fracture is suspected, the health care provider will order an X-ray. When a child has a toddler's fracture, often a fine line can be seen on the X-ray, which is the fracture. But sometimes, soon after the injury, a fracture isn't easy to see on an X-ray. In that case, the child may be treated for a suspected toddler's fracture with a walking boot to support the injury and help with pain. X-rays done later may show the fracture more clearly.