Tibial fractures are relatively frequent injuries of young children. These fractures are occasionally the cause of a childhood gait disturbance. Additionally, tibial fractures may be the result of child abuse. Consequently, the pediatrician should have knowledge concerning these injuries. In this paper, we present a review of tibial fractures in hospitalized children and describe their associations with nonaccidental trauma (NAT). Finally, we provide suggestions for improving nonmenclature clarity for isolated spiral fractures of the tibia.