This study aims to determine whether children experience difficulty attending school after an acute orthopaedic injury and, if so, what the barriers are to attendance. Seventy-eight school-aged patients receiving treatment of acute orthopaedic injuries or conditions at the authors' institution were enrolled in this prospective study. Follow-up interviews were conducted with children who could not return to school. Fifty-three percent of the children were able to return to school immediately; those who were not were absent for 35.9 days on average. Nearly three quarters of absentees attributed the nonattendance to refusal by the school, and only 36.7% received home instruction during their absence. A regression model showed that children using crutches were five times less likely to attend school than children without crutches. This study indicates that orthopaedic injuries and their treatments contribute to school absence. Refusal by the school to accommodate the injured child was the primary barrier to attendance.