Treating the Most Common Child’s Fracture

Because children’s bones are weaker and more porous than adult bones, they may require specialized treatment. Doctors treat a fracture on its type, severity and if the fracture occurs in a still-developing bone (growth plate). Pediatric fractures are more prevalent in males and are generally associated with sports, with forearm fractures, hand fractures, and carpal-metacarpal (wrist) fractures being the most common. When a bone breaks through the skin, the doctor will refer to it as a complex fracture or an open fracture. In general, children’s fractures heal faster than adults. The three most common fractures in children occur in the wrist, elbow, and ankle. The following provides information regarding these fractures.

Wrist Fractures

A child’s fracture of the wrist is the most prevalent type of fracture. They generally occur when children stretch their hands to break a fall.

Symptoms of a Child’s Fracture of the Wrist:

In children, symptoms of a broken wrist include pain, edema, and, in some cases, wrist deformity. X-ray images are analyzed to measure the kind of fracture and if the growth plate appears damaged. A buckle fracture is the most frequent form of growth plate injury, in which one side of the bone bends but does not break all the way through. Wrist fractures heal quickly and can be treated with a cast for 2 to 3 weeks.

Treatment:

Surgery may be required to realign the bones and avoid deformity in situations when the bones are misaligned or the child is older (10 – 15 years).

Elbow Fractures

Another common childhood injury is a child’s fracture of the elbow, the most common of which is a Supracondylar Humerus Fracture. It’s a fracture of the upper arm bone at its thinnest point, just above the elbow. It usually happens to kids between the ages of 5 and 7 when they fall down into an outstretched hand. This overloads the elbow, resulting in a fracture, and can occasionally be combined with a wrist injury.

Symptoms of a Child’s Fracture of the Elbow:

The following are symptoms of elbow fractures:

  • Swelling around the elbow
  • Difficulty to straighten the arm
  • Numbness in the hand due to probable nerve damage
  • Acute pain in the elbow and forearm

To detect the type and location of a fracture, X-ray scans are employed.

Treatment:

In the event of minor fractures in which the bones are not displaced, therapy consists of wearing a cast or splint for about a month to allow the fracture to heal. If the fracture appears more severe or the bones are displaced, surgery would be necessary to realign the bones and hold them in place with metal pins in order for healing to occur. Once recovery has begun, the pins are removed a few weeks following surgery.

Ankle Fractures

The third most common childhood injury is a child’s fracture of the Ankle.  These fractures impact children of varying ages in different ways. The Salter-Harris (SH) classification system classifies fractures affecting the growth plate, which shows the different types of fractures and the therapy necessary.

Symptoms of a Child’s Fracture of the Ankle:

Ankle fracture symptoms include the inability to bear weight on the ankle, soreness and edema around the ankle, and potential bone deformation or displacement.

Salter-Harris Type 1 Fractures 

The fracture of type 1 fractures slices through the growth plate, separating the bone end from the bone shaft. Type 1 fractures account for around 5% of all fractures.

Child’s Fracture Treatment:

Treatment for these fractures often does not include surgery and consists of placing the fracture in a cast to enable it to heal in place.

Salter-Harris Type 2 Fractures 

Form 2 fractures appear as the most prevalent type of ankle injury, accounting for over 75% of all fractures. This fracture breaks through the growth plate and splits a portion of the bone shaft.

Child’s Fracture  Treatment:

Treatment for these fractures often does not include surgery and consists of placing the fracture in a cast to enable it to heal in place. A method known as Closed Reduction may be necessary for rare instances. This non-surgical method allows the doctor to position the bones by pressing or tugging on them. This procedure requires sedating the child.  

Salter-Harris Type 3 & 4 Fractures 

Type 3 fractures harm both the growth plate and the joint. They are more common in children over the age of ten, when ankle fractures become more difficult to repair as the children reach puberty. Type 4 fractures cause injury to both the growth plate and the bone shaft, as well as breaking through the bone’s end. Type 3 and 4 fractures account for around 10% of all fractures. These fractures become diagnosed using X-rays or Computerized Tomography (CT) scans.

Child’s Fracture Treatment:

The treatment focuses on achieving joint congruency by casting or closure reduction. It is critical to restoring joint congruency since it may lead to arthritis in the future. Other forms of fractures include:

  • Buckle fracture also known as a compression fracture occurs when a bone is “buckled” to one side but does not crack.
  • Greenstick fracture happens when a bone bends but does not completely shatter, similar to how a short green limb from a tree may bend but not fracture.
  • Growth plate fracture occurs when there is a break in a developing bone, this is referred to as a growth plate fracture.
  • A stress fracture occurs when there is a break in a bone, this is referred to as a stress fracture.

An exam and diagnostic tests are used by your child’s healthcare practitioner to determine the diagnosis. During the examination, you will be questioned about your child’s medical history as well as how the injury occurred.

Open (complex) Fracture:

An open fracture is a life-threatening situation. This is the point at which the bone bursts through the skin. Or when there is a deep incision in the skin that exposes the bone. The objective of therapy is to alleviate discomfort, promote bone healing, and minimize complications so that your kid can resume normal use of the broken region. Treatment options may include:

  • Splint or cast. This stabilizes the damaged bone as it heals.
  • Certain medications can assist to reduce inflammation.
  • The muscles and tendons around the shattered bone are gently stretched to allow the bone ends to align and mend. It makes use of pulleys, strings, weights, and a metal frame that is placed to or above the bed.
  • Your child may require surgery to repair some types of fractured bones. Metal rods or pins are sometimes placed inside or outside the body by the surgeon to keep the bone fragments in place. This allows them to heal in the proper posture.

Other Treatments:

A cast, splint, or brace is used to support a child’s fracture, which may need to be “set” or corrected before it can be stabilized. This is referred to as reduction. The reduction procedure is carried out in two steps:

Closed reduction – when the medicine is provided to reduce discomfort and the bone is straightened without the need of an incision (cut).

Open reduction – When the damage is more extensive, surgery may be undertaken to straighten bones and stabilize using screws, plates, and wires; an incision is required, which is performed under anesthetic (child is sleeping).

At Medical City Children’s Orthopedic and Spine Specialists, we offer soft fiberglass casts. All our 4 locations (serving the Dallas metroplex) are a one-stop destination for X-ray and fracture care. If your child is in pain from a broken bone, get in touch with us today at 214-380-2426 to get the best orthopedic care for a broken bone.