Fractures and Broken Bones are Part of Growing Up: Here’s What You Need to Know

Spring is just around the corner and we are looking forward to the warm weather and outdoor fun ahead! Many children are also excited to participate in spring sports as well. At Urgent Care for Children, we encourage healthy activities but parents should also be aware of sports-related injuries and how to respond to their child’s needs when such injuries occur. Youth sports injuries occur frequently; according to a study by Stanford Children’s Health, more than 3.5 million injuries occur annually among youth athletes in the United States. One of the most frequently occurring sports injuries for kids are broken bones.

Will my child need surgery for a broken bone?

Fractures and broken bones are the fourth most common injury experienced by children under age six. Young children often experience falls, as your little one grows and becomes more engaged in physical activities like sports these injuries become nearly inevitable. Youth commonly experience four types of fractures: greenstick, torus, bend, or complete. Greenstick fractures occur when the bone bends like “green” wood breaks on one side. A torus fracture means that the bone is twisted or buckled and weakened, but not broken. Bend fractures are very common, and the bone is weakened in these instances as well but not broken. If your child experiences a complete fracture, the bone is broken all the way through. Children’s bones are more flexible and have a thicker covering that helps to absorb shock better than fully developed bones. This increased flexibility is a good thing. Children rarely need surgical repair for broken bones.

However, there are some instances in which damage to the growth plates at the end of your child’s bone can occur. If this type of damage doesn’t heal properly, the bone could grow at an angle or at a slower rate than undamaged bones. Bones that exhibit growth plate damage will need to be closely monitored by your child’s primary care provider because the degree of damage and impact on bone growth may not be fully determined for up to a year or more. Your child’s pediatrician will be able to determine whether surgery is needed. Such contact sports as football, soccer, and basketball, or recreational activities, such as skiing and skateboarding have been known to cause growth plate damage. Another type of fracture that is concerning and may result in surgery are those occurring around the elbow. This area is prone to heal abnormally and your child may be referred to an orthopedic specialist.

What are the signs of a broken bone or fracture?

It can be difficult to know whether your child has a fracture or broken bone. Typically, fractures present with swelling in the affected area. Your child could be in pain or discomfort, but they may still be able to move their injured limb. It is important to note that the ability to move does not rule out a fracture.

What should I do to help relieve my child’s pain before we are able to see a doctor?

After notifying your child’s pediatrician, there are a few simple things you can do until you’re able to visit your pediatrician or visit your pediatric urgent care center. Use the R.I.C.E Method:

Rest

  • Do not use the injured area until seen for further evaluation by a pediatric provider
  • Use an improvised sling or rolled-up newspaper or magazine as a splint to protect the injury from unnecessary movement

Ice

  • If your child is older, apply an ice pack or cold towel to the injured area to help decrease pain and swelling (Do not apply ice to infants or toddlers, extreme cold can injure their delicate skin)
  • Use ice 15 – 20 minutes at a time
  • Crushed/cubed ice or frozen peas/corn works best, avoid using chemical cold packs
  • Always ice for the first 48 – 72 hours after injury
  • Never sleep with ice on the injured area

Compression

  • Elastic wrap/compression sock should be used to reduce swelling
  • Apply wrap beginning below the injured area and wrapping upward
  • Always leave toes/fingers exposed
  • Watch for numbness, discoloration or temperature changes (loosen wrap if needed)
  • Do not sleep with wrap on the injured area

Elevation

  • Use gravity to control swelling
  • Prop injured area higher than the heart

In the case of extreme injury, for instance, if part of the area is open and bleeding, or if the bone is protruding through the skin, place firm pressure on the wound; then cover it with clean (preferably sterile) gauze. Do not try to put the bone back underneath the skin. After seeking treatment, be watchful of fever, this may indicate that the wound has become infected. It is also imperative that you do not try to move your child by yourself if you suspect a broken bone. Call 9-1-1 for an ambulance; let the paramedics supervise his or her transportation and make your child as comfortable as possible.

What should I expect when my child is screened for a broken bone?

When your child is examined for a fracture or break, an x-ray will likely be performed to determine the extent of the damage. Minor fractures will typically be set by using a plaster or fiberglass cast. In some cases, an immobilizing splint is all that is required to encourage proper healing. If bones are out of alignment, or it appears that some damage to growth plates has occurred, an orthopedic consultation may be recommended. If surgery is required, a cast will be used until the bone has healed. Parents may be relieved to know that children usually take about half the time that adult bones require, or less to heal. Your child’s primary care pediatrician will continue to monitor how their bones are healing and will likely order periodic x-rays.

Lastly, if your child is placed in a cast you will want to be observant of any changes. If your child experiences increased pain or numbness, has pale or blue fingers or toes, call your pediatrician. This could mean that their injury has swollen and they need the cast adjusted to allow more room. Swelling like this compresses nerves, muscles and blood vessels which could cause permanent damage. Without a proper fit, the bone cannot heal correctly.

Before engaging in youth sports this spring, make sure to speak with your primary care provider about your child’s health history. Your family’s pediatrician is best suited to perform sports physicals and will counsel you about any specific precautions your child should take before engaging in youth sports. As always, Urgent Care for Children will be standing by in any of our convenient locations in Alabama, Tennessee and Louisiana to attend to any urgent care needs that may occur late nights and weekends all 365 days a year. All of our UC4C clinics are equipped with x-ray machines to provide thorough screenings and we always share relevant information with your family pediatrician.