Patient education: Fractures in children (The Basics)

What is a fracture? — 

This is a broken bone. The bone might crack, break all the way through, or shatter.

There are different types of fractures, depending on which bone breaks and how. Examples include:

●"Open" fracture – This is when the bone sticks out of the skin or can be seen through a wound.

●"Closed" fracture – This is when the bone does not stick out of the skin and cannot be seen through a wound.

●"Stress fracture" – This is caused by overuse. It often happens in the foot or shin bones. It is more common in people who do an activity over and over, such as running, jumping, or dancing.

●"Avulsion" fracture – This is when a person moves a joint forcefully, and a ligament or tendon stretches or tears. It can pull so hard on the bone a small part of the bone cracks or breaks off.

Compared with adults' bones, children's bones are more likely to bend or break only partway. Special kinds of fractures children can get include:

●"Buckle" fractures – This is when the bone is compressed but does not break.

●"Growth plate" fractures – This is when the growing part of the bone near the end breaks, often where a ligament attaches to it.

●"Greenstick" fractures – This is when the bone bends and cracks, but not all the way through.

What are the symptoms of a fracture? — 

Symptoms depend on which bone breaks and the kind of break. Common symptoms can include:

●Pain, swelling, or bruising over the area

●The area looking abnormal, bent, or not the usual shape

●Not being able to move or put weight on that part of the body

●Numbness in the area of the broken bone

If a fracture injures a nerve, this can also cause symptoms in nearby areas. For example, a break to the upper arm bone might cause pain, tingling, or weakness in the elbow and wrist.

Is there a test for a fracture? — 

Yes. Your child's doctor or nurse will ask about your child's symptoms, do an exam, and take an X-ray.

They might do other imaging tests, such as a CT, bone scan, or ultrasound. These create pictures of the inside of the body.

How are fractures treated? — 

Treatment depends, in part, on the type of fracture 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.

Your child might need to see an expert in treating broken bones, called an "orthopedic surgeon." But most fractures in children heal without surgery.

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

If the ends of their broken bone are not in line with each other, their doctor might need to line them up. To do this, they might be able to move your child's bone to the correct position without doing surgery, and then put a cast, splint, or brace on.

If needed, they can also do surgery to put your child's bone back in position. This can involve:

●Using screws, pins, rods, or plates to fix a bone inside the body

●Putting pins or screws through the skin and into the bone, and then attaching the pins or screws to a bar outside of the skin

The doctor will also treat your child's pain. If your child has a severe fracture, they can prescribe a strong pain medicine. If your child has a mild fracture, they might recommend you give your child an over-the-counter pain medicine. These include acetaminophen (sample brand name: Tylenol), ibuprofen (sample brand names: Advil, Motrin), and naproxen (sample brand name: Aleve). Do not give aspirin to children younger than 18 years old.

After their bone heals, their doctor might recommend your child work with a physical therapist (exercise expert). They can show you and your child exercises and stretches to strengthen their muscles and help their joints move more easily.

How long do fractures take to heal? — 

It depends on the body part involved and the type of fracture. Most take weeks to months to heal. Fractures in children usually heal faster than those in adults.

How can I help my child's fracture heal? — 

Follow all their doctor's instructions while your child's fracture is healing. For example, they will probably recommend your child eat a healthy diet that includes getting enough calcium, protein, and vitamin D (figure 1 and table 1).

They will also probably recommend your child:

●Not play certain sports while their fracture heals

●Not get their cast wet, if their doctor says it's not waterproof

When should I call the doctor or nurse? — 

After treatment, your child's doctor or nurse will tell you when to call. In general, call if:

●Your child's pain, swelling, or other symptoms get worse.

●Your child gets a fever.

●Your child can't move part of their body.

●Your child gets their cast wet, and it's not supposed to get wet.

How can I help prevent my child from getting another fracture? — 

To protect your child from getting hurt, you should:

●Have them wear safety gear when they bike, ride a scooter, rollerblade, or do activities where they could get hurt. Safety gear can include helmets, elbow pads, knee pads, wrist guards, and shin pads.

●Have them use a proper-sized car seat or wear a seatbelt every time they ride in a car.

●Make sure playground equipment is safe.

To help your child develop strong bones so they don't break easily, you should:

●Offer your child foods and drinks with a lot of calcium, vitamin D, and protein. Calcium and vitamin D are nutrients that help keep bones strong.

●Encourage your child to get regular exercise. Activities like running, jumping, and playing sports help strengthen bones.

More on this topic

Patient education: Fractures in children – Discharge instructions (The Basics)
Patient education: Setting a broken bone in children (The Basics)
Patient education: Surgery to fix a broken bone (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: Pin, plate, or screw removal (The Basics)
Patient education: Calcium and vitamin D for bone health (The Basics)
Patient education: Facial fractures (The Basics)
Patient education: Nose fracture (The Basics)
Patient education: Neck fracture (The Basics)
Patient education: Vertebral compression fracture (The Basics)
Patient education: Clavicle fracture (The Basics)
Patient education: Shoulder or upper arm fracture (The Basics)
Patient education: Elbow fracture (The Basics)
Patient education: Forearm fracture (The Basics)
Patient education: Wrist fracture (The Basics)
Patient education: Hand fracture (The Basics)
Patient education: Finger fracture (The Basics)
Patient education: Hip fracture (The Basics)
Patient education: Pelvic fracture (The Basics)
Patient education: Femur fracture (The Basics)
Patient education: Patella fracture (The Basics)
Patient education: Lower leg fracture (The Basics)
Patient education: Ankle fracture (The Basics)
Patient education: Heel or foot fracture (The Basics)
Patient education: Toe fracture (The Basics)