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The harder kids play, the harder they fall. The fact is, broken bones, or fractures, are common in childhood. Here are the answers to some frequently asked questions about fractures (broken bones) in children.
How do most childhood fractures occur?
Most bones are broken when children are at play or participating in sports. Children often fall, and it is a natural instinct to throw the hands out in an attempt to stop the fall. Therefore, most fractures occur in the upper extremities: the wrist, the forearm, and above the elbow.
How do doctors tell whether a bone is broken?
A doctor can often tell whether a bone is broken just by looking at the injured area. There may be swelling or bruising, or the limb might look deformed. It may also hurt to move, touch, or press on it. X-rays are used to confirm a diagnosis, although some fractures can be difficult to detect on X-rays. Sometimes, in severe breaks, the broken bone may be poking through the skin.
What happens in the cast room?
The child is prepared to have the fracture site casted. The procedure of setting a bone is known as a closed reduction. Reduction involves manipulating the fracture or displaced ends of the bone into proper alignment, and then holding the realigned bone in place. Casts are made from either plaster of paris or synthetic (fiberglass) material. Plaster of paris is easier to mold over difficult fractures, but is heavier and less resistant to water. Synthetic material comes in many bright colors, is lighter and cooler, and is often used for less complicated fractures.
What is the difference between an open fracture and a closed fracture?
A fracture that does not break the skin is called a closed fracture. When the ends of the broken bone break through the skin, the fracture is called an open (or compound) fracture. Open fractures need to be cleaned thoroughly in the sterile environment of the operating room before they are set because the bone's exposure to the air poses a risk of infection.
What is a buckle or torus fracture?
In young children, one side of the bone can bend, raising a little buckle, and this is called a buckle or torus fracture. This common bone break usually heals in 3 to 4 weeks.
What is a "greenstick" fracture?
Just as the name implies, this fracture resembles what would happen if one tried to break a green stick. This is a partial fracture in which one side of the bone is broken and the other side bends.
How long does it usually take for a broken bone to heal in a child?
Fractures heal at different rates depending upon the age of the child and the type of fracture. Young children may heal in as little as 3 weeks, although it may take 6 weeks for the same kind of fracture to heal in teens.
Why are some fractures treated in traction?
Certain fractures of larger long bones, such as the femur (thigh bone), are difficult to keep straight in a cast. Some of these fractures are treated for a few days in traction. When the fracture begins to show early healing, a cast can then be applied to hold the bone straight while healing is completed.
Can plaster of paris casts get wet?
Absolutely not! A wet cast could cause irritation or inflammation of the skin.
How do waterproof casts work?
Fiberglass casts with waterproof liners allow children to continue bathing or even go swimming during the healing process. The liner allows for evaporation of water and sweat. The liner is fragile. It must be protected to allow it to function properly. Your child's doctor will determine if the fracture may be safely treated with a waterproof cast.
What if your child has an itch in the cast?
Try blowing some air in the cast with a hair dryer - be sure to use the cool setting. You should never pour baby powder or oils in the cast, or try to reach the itch with a pencil or hanger - these fixes could irritate your child's skin and cause an infection.
Are there conditions that cause children to be more likely to suffer broken bones?
Yes. Children with an inherited condition known as osteogenesis imperfecta have bones that are brittle and more susceptible to breaking. Children who participate in sports or are generally active are more likely to experience fractures than their more sedentary counterparts. To reduce risks, be sure your child is wearing the recommended protective gear.
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