BROKEN BONES AND FRACTURES

QUESTIONS AND ANSWERS

If you suspect your child has a fractured or broken bone, it is important to see a pediatric orthopedic physician as soon as possible after the injury. Our Pediatric Orthopedic Surgeons often see patients who have broken bones due to playing on monkey bars, jumping on trampolines, contact sports like football and lacrosse, riding ATVs/dirt bikes, jumping in bounce houses, and riding down slides in a parent’s lap. Sports injuries are among the most common fractures and are usually caused by collisions, pileups, twisting, or falling.

Our Specialty

Diagnosing a broken bone is often hard without an X-ray exam and a medical exam, which is why we have an X-ray located in our office. Nevertheless, children who exhibit intense pain, swelling, bruising, bleeding, numbness, or tingling, are unable to walk, or walk crooked, and not using or favoring an arm or leg should immediately see a doctor. Common pediatric fractures include buckle fractures.

Treating children’s broken bones is the specialty of our pediatric orthopedic surgeons, and expert patient care is our focus as a bone can fracture in several different ways.  Ankle injuries and arm injuries are common fractures in children that require immediate treatment.
To lower a child’s risk for broken bones and other injuries, make sure your child gets plenty of sleep, eats a balanced diet, stays hydrated, wears protective gear for their sport or activity, warms up and stretches muscles and joints before activities, and plays in areas that are safe and free of holes, ruts, and debris. Protect your little athlete by making sure he or she knows how to play the game, is properly supervised by adults who know CPR, and is outfitted with the proper equipment and safety gear.

If you’re looking for an orthopedic specialist, orthopedic surgery, orthopedic surgeon, or orthopedics near you, consider <strong>Medical City Children’s Orthopedics and Spine Specialists</strong>, serving Dallas, Arlington, McKinney, and Frisco, TX.

Symptoms of a Broken Bone

Children who exhibit any of the following symptoms may indicate a broken bone or fracture and should see a doctor immediately:

• Intense pain or pain that lasts longer than a few days after a fall or injury
• Swelling, bruising, or bleeding
• Numbness and tingling
• Not using or favoring an arm or leg
• Unable to walk or walking is crooked
• A child who can’t talk keeps pointing to a body part or cries when it is moved or touched

• Gets plenty of sleep, eats a balanced diet, and stays hydrated
• Wears protective gear for their sport or activity
• Warms up and stretches muscles and joints before activities
• Plays in areas that are safe and free of holes, ruts, and debris

Protect your little athlete by making sure he or she knows how to play the game, is properly supervised by adults who know CPR, and is outfitted with the proper equipment and safety gear.

Common Pediatric Fractures Include

Buckle Fractures

Treating children’s broken bones is our specialty and expert patient care is our focus as a bone can fracture in several different ways. For example, a buckle fracture is the most common fracture in the arms and feet of young children. Therefore, this form of fracture is ‘incomplete’, which means that the bone does not break completely; instead, the bone bends and has a small crack in it. Another type is a complete break of the bone that does not damage surrounding tissue or tear through the skin.  As such, this is known as a closed (or simple) fracture. However, a break that damages the surrounding skin and penetrates the skin is known as a compound fracture or an open fracture. Furthermore, compound fractures are generally more serious than closed fractures because they can get infected.

Most human bones are surprisingly strong and can generally stand up to strong impacts or forces. However, if that force is too powerful, or there is something wrong with the bone, it can fracture. Because children’s bones are more elastic, when they do have fractures, they appear differently that those of an adult. Children also have growth plates – areas of growing bone – at the end of their bones which sometimes become damaged. Therefore, it is important for children to see an Pediatric Orthopedic Surgeon when they experience a fractured bone.

Ankle Injuries

Ankle injuries are common complaints in both emergency rooms and family physicians’ offices. Since they are serious and require immediate attention, parents should seek and contact a qualified and highly skilled pediatric orthopedic doctor.   Approximately 1 million ankle injuries occur annually in the United States. In addition, treatment options differ according to the grade of injury.  Grade I and grade II sprains usually respond to rest and immobilization, while grade III sprains require casting or possibly surgery.

Ankle fractures are more severe than ankle sprains and require immediate treatment. When there’s a complete or partial break due to trauma, the child cannot put any weight on the ankle. Then parents will see swelling, bruising, and severe pain.  Also, an ankle fracture can be caused by harsh accidental movements, such as twisting of the ankle in everyday sports or activities. Car accidents can also cause ankle fractures, especially high-impact ones. In addition, tripping, falling, rolling an ankle, or rotating it the wrong way can create an ankle fracture.

Arm Injuries

When a child breaks an arm, the doctor will first carefully examine the injured area for tenderness, redness, and swelling. Then the doctor will have an X-ray, MRI, or CT scan taken so that the arm can be observed and checked for damage to the bone, muscles, or blood vessels.

Our expert doctors treat broken arms depending on the specific location and degree (severity) of the break and your child’s age, overall health, and medical history. Ultimately, our doctors will determine your child’s treatment plan and follow-up based on their physical exam and other tests.

Broken Collarbone

A broken collarbone, which is also referred to as a broken clavicle, is a common injury, particularly in children and teenagers. The collarbone connects the upper part of the breastbone with the shoulder blade. The most common causes of a broken collarbone in children include falls and sports injuries. Infants can sometimes break their collarbones during the birth process.

Parents should promptly seek medical attention for a broken collarbone. Most patients heal well with ice, pain relievers, a sling, physical therapy, and time. But a complicated break might require surgery to realign the broken bone and to implant plates, screws, or rods into the bone to hold the bone in place during healing.

Upon examination, our doctors will ask about your child’s injury and symptoms. The doctor will also examine your child’s shoulder and may press gently on the collarbone. Our Specialist may also check the feeling and strength in your child’s arm, hand, and fingers. An X-ray or CT scan will clearly identify the fracture. Your child may be given a contrast liquid to help a collarbone fracture show up better in the pictures. Tell the healthcare provider if your child has ever had an allergic reaction to a contrast liquid.  Upon an official diagnosis, the doctor will discuss an individualized treatment plan with the parents.

Elbow Injuries

The elbow is a joint that connects the humerus bone of the upper arm with the radius and ulna bones of the lower arm through a complex network of muscles, ligaments, and tendons. The elbow is much more than a simple hinge, the unique arrangement of the elbow allows for rotation.

Treatment of injuries and diseases requires specialized knowledge. Our physicians are recognized as leaders in the diagnosis and treatment of elbow problems. They provide an extraordinary base of shared knowledge with leading-edge kids’ surgery and treatment.

Hand Injuries

The hand consists of dozens of bones, joints, ligaments, tendons, and muscles that need to work together seamlessly in a variety of positions hundreds of times a day. As such, hands often require highly specialized medical care when they become injured.

Hip Injuries

The following are just a few of the problems that we treat relating to the hips.

• Hip Bursitis
• Contusions (Hip Pointer)
• Stress Fractures
• Hip Labral Tear
• Femoroacetabular Impingement
• Osteitis Pubis
• Snapping Hip Syndrome
• Traumatic Hip Subluxation & Dislocation

As with all Hip Injuries, the most highly skilled doctor who knows about growth plates and specializes in Children should be the doctor who treats the injury . 

Knee Injuries

Our compassionate team of Orthopedic Specialists with convenient offices in Dallas, Arlington, McKinney, and Frisco, TX will sit down with you and your child to perform a detailed physical examination to determine your child’s diagnosis. Your physician will often order an X-ray exam. After careful interpretation of your child’s X-ray and the physical exam, your Pediatric Orthopedic Specialist will discuss a treatment plan with you and your child. If your child needs surgery or a cast for a fracture, we can schedule you for that day or the very next morning. There’s no sitting in waiting rooms. We make sure your child gets seen right away.

Orthopedic Surgeon

Medical City Children’s Orthopedics Spine Specialists have offices in Dallas, Arlington, McKinney, and Frisco, Texas.  More importantly, the practice is led by a team of highly qualified, experienced orthopedic surgeons who are recognized as one of the region’s leaders in diagnosing and treating orthopedic and sports medicine injuries. Furthermore, the practice is well recognized for the scope of services it offers, as well as its doctors’ medical expertise.  Also, our orthopedic surgeons are board-certified, having completed rigorous training at the finest medical institutions in the country. Additionally, they specialize in all aspects of orthopedic care for children, including disorders of the knee, shoulder, elbow, hip, spine, foot, and ankle; trauma; and arthritis.

Our Orthopedic Surgeons have training in several subspecialties, including surgery of the upper extremities; minimally invasive joint replacements and reconstructive surgery; arthroscopic surgery; surgery of the spine that includes scoliosis; sports medicine; and leg, ankle, and foot surgery.

Each patient’s treatment program gets tailored to the patient’s specific needs, with ongoing reevaluations and adjustments as the recovery progresses. Because the physicians can perform the diagnostic studies to include X-rays in the comfort and convenience of our offices, they get your test results quickly, allowing for a more immediate determination of your child’s treatment options.

Whether your child plays sports, just runs around with friends like kids do, or suffers an injury, the doctors and surgeons at the Medical City Children’s Orthopedics and Spine Specialists will provide surgery when necessary. Furthermore, the team offers the most advanced treatment, which combines the latest in cutting-edge technology using minimally invasive techniques or sophisticated surgery to treat children and get them back to normal as quickly as possible.

Call our office today or schedule an appointment online to come in for a consultation about your child.

Cast Care Instructions

What is a Cast?

Casts are custom-made protective devices used to keep broken bones from moving after an injury.  In addition, they can also decrease pain and muscle spasms during the healing process.   Upon the cast being applied, parents will see that it is fiberglass and waterproof.

Please wait 4-5 hours before getting the cast wet as this will allow for the fiberglass on top to set. Incidentally, the waterproof casting material helps pull water away from the skin. After getting wet, it takes approximately 1 hour to dry.

Sometimes, casts are used to treat conditions other than broken bones, such as severe sprains, growth plate injuries, and overly tight muscles.

Care:

Elevate the injured arm or leg on a pillow for the first 24-48 hours after injury or surgery. If an arm or leg becomes too swollen at the time of cast placement, your doctor may partially open/split the cast on one or both of the sides to prevent the cast from becoming too tight, and to allow for swelling.

• Keep the cast clean and dry
• Itching: Some itching is normal when wearing a cast and is best treated by blowing a hair dryer on COOL setting only down either end of the cast. Meanwhile, do not stick anything in the cast to scratch or itch.
• If your child was given a sling, he or she must wear this when they are upright until otherwise specified by your physician

Cautionary Measures

• Do not put anything in the cast (hangers, pencils, money, etc.)
• No powders, ointments, or lotions in or around the cast
• Do not trim or cut the cast
• Avoid dirt or sand in the cast

Warning signs:

If your child experiences any of these symptoms or you have other concerns, call your doctor’s office immediately for instructions:

• Increasing pain or the child complaining about the cast being tight
• Numbness or tingling in the fingers or toes
• Excessive swelling at the ends of the cast
• Inability to move the fingers or toes
• Fever greater than 101 degrees
• Foul odor or drainage from the cast

Care:

• Your child can go swimming and take a shower or bath
• Shake/Drain the water out of the cast by holding the hand/foot down towards the floor and lifting the hand/foot up towards the sky
• Avoid getting anything in or down the cast
  • This includes sand, lake debris, lotions, powders, toys, etc.
  • The skin can become irritated, and itchy, and cause breakdown or sores
• Do NOT stick anything in the cast to scratch the skin
  • If your skin gets scratched it can cause skin infection leading to worse problems
  • If soap gets in the cast just rinse thoroughly with clean water

Itching:

When a cast is in place, the skin under the cast may itch.

Recommendations to help with the itching include:

• A hairdryer on a COOL setting
• Benadryl by mouth over the counter (recommended dosage as noted on the packaging)
• Tapping on the cast

Cast Removal:

Finally, the doctor will remove the fiberglass or plaster cast in the doctor’s office with a special tool called a cast saw.  Importantly, this special saw vibrates but does not rotate, so the skin underneath the cast is not injured during cast removal.  However, the noise of the cast saw sometimes bothers children, but removing the cast will not hurt.  For the purpose of Cast removal, it is easiest with a dry cast so please do not wet the cast 8-12 hours prior to your appointment.

Selecting a pediatric orthopedic doctor for your child is a crucial decision that requires careful consideration. By seeking recommendations, researching credentials, assessing hospital affiliations, reviewing patient testimonials, evaluating communication and bedside manner, considering the supportive team, discussing treatment options, seeking second opinions, prioritizing accessibility, and trusting your instincts, you can make an informed choice. Remember, finding the right orthopedic doctor will ensure that your child receives the best possible care, leading to optimal outcomes and a healthier, happier future. The Medical City Children’s Orthopedics and Spine Specialists doctors only treat children.  With offices in Arlington, Dallas, Frisco, and McKinney, Texas, Doctors Shyam Kishan, Richard Hostin, and Kathryn Wiesman have spent years studying children’s health and have devoted their lives to treating them.

____________________

Footnote:

American Academy of Orthopaedic Surgeons: Fractures (Broken Bones)