Patient education: Fractures in children – Discharge instructions (The Basics)

What are discharge instructions? — Discharge instructions are information about how to take care of your child after getting medical care for a health problem.

Below is general information about caring for your child after a fracture.

What is a fracture? — A "fracture" is another word for a broken bone. There are different kinds of fractures, depending on how the bone breaks. When a bone breaks, it might crack, break all of the way through, or shatter.

If a broken bone sticks out of the skin or can be seen through a wound, doctors call it an "open" fracture. If the bone does not stick out of the skin or cannot be seen through a wound, doctors call it a "closed" fracture.

How are fractures treated? — Treatment depends, in part, on the type of fracture your child has and how serious it is. The goal of treatment is to have the ends of the broken bone line up with each other so the bone can heal.

●If the ends of their broken bone are already in line with each other, the doctor might put a cast, splint, or brace on that part of the body. This will keep the bone in the correct position so it can heal.

●If the ends of their broken bone are not in line with each other, the doctor will need to line them up. To do this, they can sometimes move the bone to the correct position without doing surgery, and then put a cast, splint, or brace on. In other cases, surgery is required to line up the bones.

How do I care for my child at home? — Ask the doctor or nurse what you should do when you go home. Make sure that you understand exactly what you need to do to care for your child. Ask questions if there is anything you do not understand.

You should also:

●Follow the doctor's instructions for having your child wear the splint, brace, or cast. This supports and protects the bone as it heals. Some fractures are placed in a cast right away. Other fractures are not put in a cast until after the swelling goes down.

●Do not get the cast wet unless the doctor says that it is waterproof.

●Follow instructions for limiting your child's activity and movement until the bone is healed. The doctor or nurse will tell you what activities are safe for your child to do.

•If the broken bone is in your child's leg, ankle, or foot, they might need to use crutches or a special shoe or boot. The doctor or nurse will tell you how much weight your child can put on their leg with the broken bone. This can range from no weight-bearing to full weight-bearing.

•If the broken bone is in your child's shoulder, arm, wrist, or hand, they might need to use a sling.

●Prop the injured body part on pillows, keeping it above the level of their heart. This might help lessen pain and swelling.

●Give your child an over-the-counter pain medicine, if the doctor recommended this. These include acetaminophen (sample brand name: Tylenol) and ibuprofen (sample brand names: Advil, Motrin).

●Follow the instructions for taking stronger pain medicines, if the doctor prescribed them.

●Have your child use ice to help with pain and swelling, if needed:

•Put a cold gel pack, bag of ice, or bag of frozen vegetables on the injured area every 1 to 2 hours, for 15 minutes each time. Put a thin towel between the ice (or other cold object) and the skin.

•Use the ice (or other cold object) for at least 6 hours after the injury. Some people find it helpful to ice longer, even up to 2 days after their injury.

●Offer your child a healthy diet that includes plenty of calcium, vitamin D, and protein (figure 1).

●Have your child work with a physical therapist (exercise expert) once the fracture has started to heal, if the doctor recommended this. This way, the child can learn exercises to make their muscles stronger or to help with their range of motion. This is very important to help your child recover as quickly as possible and get back to their usual daily activities.

What follow-up care does my child need? — The doctor will want to see your child again to check on their progress. Go to these appointments.

When should I call the doctor? — Call the doctor or nurse for advice if:

●Your child's arm, hand, leg, or foot of the limb with the broken bone becomes very swollen.

●Your child's fingers or toes turn cold, blue, gray, or numb.

●Your child damages their cast or splint.

●Your child has very bad pain that is not helped by their pain medicine.

More on this topic

Patient education: Fractures (The Basics)
Patient education: Setting a broken bone in children (The Basics)
Patient education: How to care for your child's cast (The Basics)
Patient education: How to care for a splint (The Basics)
Patient education: Surgery to fix a broken bone (The Basics)

Patient education: Cast and splint care (Beyond the Basics)