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Treating the Most Common Child’s Fracture

 

Broken boneBecause 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 with a cast for 2 to 3 weeks.

Treatment:

Doctors will suggest surgery to realign the bones and avoid deformity in situations when the bones do not align correctly or the child’s age is above 10.

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 also injures the wrist.

Symptoms of a Child’s Fracture of the Elbow:

The following identify 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, doctors will order X-ray scans.

Treatment:

In the event of minor fractures in which the bones do not become 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 become 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 begins, the pins get removed a few weeks following surgery.

Ankle Fractures

The third most common childhood injury occurs when a child fractures his or her 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 Fracture 

A type 1 fracture 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. The doctor may use Closed Reduction 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 occur 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 fractures happen when breaks occur in a developing bone, this refers to as a growth plate fracture.
  • A stress fracture occurs with tiny cracks in a bone. They’re caused by repetitive force, often from overuse

An exam and certain tests provide your child’s doctor with the information to determine an exact diagnosis. During the examination, the parent will answer questions about the child’s medical history as well as how the injury occurred.

Open (complex) Fracture:

An open fracture can become a life-threatening situation. An open fracture, which is also called a compound fracture, is where the bone bursts through the skin. Or when a deep incision in the skin exposes the bone. The objective of treatment is to alleviate pain and discomfort, promote bone healing, and minimize complications so that your child 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 get gently stretched to allow the bone ends to align and mend. It makes use of pulleys, strings, weights, and a metal frame that gets placed above the bed.
  • Your child may require surgery to repair some types of fractured bones. Metal rods or pins become 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:

The doctor will use a cast, splint, or brace to support a child’s fracture, which may need “setting” or correcting before stabilizing. This is referred to as reduction and is carried out in two steps:

Closed reduction –  Medicine is provided to reduce pain and discomfort and the bone is straightened without the need for an incision.
Open reduction – When extensive damage occurs, doctors will perform surgery to straighten and stabilize bones using screws, plates, and wires.

At Medical City Children’s Orthopedic and Spine Specialists with offices in Dallas, Arlington, Frisco, and McKinney, Texas, we offer soft fiberglass casts. All of 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 214-556-0590. to get the best orthopedic care for a broken bone.

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American Academy of Pediatrics: Children and Broken Bones