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Broken Bones
The harder kids play, the harder they fall. The fact is, broken
You or your child heard a snap or a grinding noise during the injury.
There's swelling, bruising, or tenderness around the injured part.
It's painful for your child to bear weight on the injury, touch it, press on it, or move it.
The injured part looks deformed. In severe breaks, the broken bone may be poking through the skin.
What Do I Do?
If you suspect that your child has a fracture, you should seek medical care immediately.
Do not move the child — and call for emergency care — if:
- the child may have seriously injured the head, neck, or back
- the broken bone comes through the skin. Apply constant pressure with a clean gauze pad or thick cloth, and keep the child lying down until help arrives. Don't wash the wound or push in any part of the bone that's sticking out.
For less serious injuries, try to stabilize the injury as soon as it happens by following these quick steps:
- Remove clothing from the injured part. Don't force a limb out of the clothing, though. You may need to cut clothing off with scissors to prevent causing your child any unnecessary additional pain.
- Apply a cold compress or ice pack wrapped in cloth.
- Place a makeshift splint on the injured part by:
- keeping the injured limb in the position you find it
- placing soft padding around the injured part
- placing something firm (like a board or rolled-up newspapers) next to the injured part, making sure it's long enough to go past the joints above and below the injury
- keeping the splint in place with first-aid tape
- Seek medical care and don't allow the child to eat, in case surgery is needed.
Different Types of Fractures
A doctor may be able to tell whether a bone is broken simply by looking at the injured area. But the doctor will order an X-ray to confirm the fracture and determine what type it is.
Reassure your child that, with a little patience and cooperation, getting an X-ray to look at the broken bone won't take long. Then, he or she will be well on the way to getting a cool — maybe even colorful — cast that every friend can sign.
For little ones who may be scared about getting an X-ray, it might help to explain the process like this: "X-rays don't hurt. Doctors use a special machine to take a picture to look at the inside of your body. When the picture comes out, it won't look like the ones in your photo album, but doctors know how to look at these pictures to see things like broken bones."
However, a fracture through the growing part of a child's bone (called the growth plate) may not show up on X-ray. If this type of fracture is suspected, the doctor will treat it even if the X-ray doesn't show a break.
Children's bones are more likely to bend than break completely because they're softer. Fracture types that are more common in kids include:
- buckle or torus fracture: one side of the bone bends, raising a little buckle, without breaking the other side
- greenstick fracture: a partial fracture in which one side of the bone is broken and the other side bends (this fracture resembles what would happen if you tried to break a green stick)
Mature bones are more likely to break completely. A stronger force will also result in a complete fracture of younger bones. A complete fracture may be a:
- closed fracture: a fracture that doesn't break the skin
- open (or compound) fracture: a fracture in which the ends of the broken bone break through the skin (these have an increased risk of infection)
- non-displaced fracture: a fracture in which the pieces on either side of the break line up
- displaced fracture: a fracture in which the pieces on either side of the break are out of line (which might require surgery to make sure the bones are properly aligned before casting)
Other common fracture terms include:
- hairline fracture: a thin break in the bone
- single fracture: the bone is broken in one place
- segmental: the bone is broken in two or more places in the same bone
- comminuted fracture: the bone is broken into more than two pieces or crushed
Getting a Splint or Cast
The doctor might decide that a splint is all that's needed to keep the bone from moving so it can heal. Whereas a cast encircles the entire broken area and will be removed by the doctor when the bone is healed, a splint usually supports the broken bone on one side.
When the doctor puts on a splint, a layer of cotton goes on first. Next, the splint is placed over the cotton. A splint may be made of stiff pieces of plastic or metal or can be molded out of plaster or fiberglass to fit the injured area comfortably. Then cloth or straps (which usually have Velcro) are used to keep the splint in place. The doctor might need to readjust the splint later, or you and your child might get instructions on how to do it at home. Your child might be allowed to remove it carefully to take a bath.
However, most broken bones will need a childproofing your home, making sure kids always wear helmets and safety gear when participating in car seats and seat belts for kids at every age and stage.
If your child does get a broken bone, remember that even though it can be frightening, a fracture is a common, treatable injury that many kids experience at one time or another. With a little patience, your child will be back to playing and running around before you know it.
Reviewed by: Peter G. Gabos, MD