Patient education: Setting a broken bone in children (The Basics)

What is a fracture? — A "fracture" is another word for a broken bone. There are different types 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 that the bone can heal.

If the ends of the broken bone are not in line with each other, the doctor will need to line them up. To do this, they can sometimes move your child's bone to the correct position without doing surgery. This is called "setting" the bone. Doctors also call it "closed fracture reduction."

After the bone is set, the doctor will put a cast, splint, or brace on so it can heal.

What happens when setting a broken bone? — When it is time for the doctor to set your child's broken bone:

●Your child might get an "IV," which is a thin tube that goes into a vein. This can be used to give them fluids and medicines.

●Your child will get anesthesia medicines. This is to make sure that they do not feel pain during the procedure. Types of anesthesia include:

•Local – This type of anesthesia uses medicine to numb a small part of the body so your child doesn't feel pain.

•Regional – This type of anesthesia blocks pain in 1 area of the body, such as an arm, a leg, or the lower half of the body.

Your child might also get sedative medicines. These medicines help them relax, feel sleepy, and not remember the procedure.

●Your child might get medicines to help control pain during the procedure.

●The doctors and nurses will monitor your child's breathing, blood pressure, and heart rate during the procedure.

●The doctor will carefully move the bones so they are back in line. After the bones are in the right place, the doctor will use a splint or cast to hold the bone in the correct position as it heals.

●The length of the procedure will depend on the type and location of the fracture and how easy it is to get the bones in line.

What happens after setting a broken bone? — After the procedure, the staff will watch your child closely as their sedation or anesthesia wears off. Most children are able to go home on the same day.

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.

●If your child got a splint or brace, follow the doctor's instructions for wearing it. 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 a cast wet unless the doctor says that it is waterproof.

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

●Have your child prop the injured arm or leg on pillows, keeping it above the level of their heart. This might help lessen pain and swelling.

●The doctor might recommend an over-the-counter pain medicine. These include acetaminophen (sample brand name: Tylenol), ibuprofen (sample brand names: Advil, Motrin).

●Some people get a prescription for stronger pain medicines to give for a short time. Follow the instructions for taking these medicines.

●Ice can help with pain and swelling:

•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.

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

What are the risks of setting a broken bone? — The doctor will talk to you about all of the possible risks, and answer your questions. Possible risks include:

●The bone not healing correctly

●Weakness

●Ongoing pain

●Surgery might be needed if the bone does not heal properly

●Nerve damage

●Blood clots

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

●Your child has less feeling or movement in their toes or fingers.

●The arm or leg in the splint or cast becomes swollen or starts to hurt more.

●The skin becomes red or irritated around the cast, or redness starts to spread up their arm or leg.

●The splint or cast becomes too tight and uncomfortable, or their fingers or toes turn pale, blue, or gray.

●There is a bad smell or drainage coming from the splint or cast.

●The cast feels too loose, you notice a crack in the cast, or the cast becomes soft.

●The cast gets wet, and it is not supposed to get wet.

More on this topic

Patient education: Fractures (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)