Fractures in children


What is it about ?

When a bone is broken, it is called a fracture. In children, the bone is more flexible than in adults; with him, the fracture is therefore not always complete. Bone can bend and break on one side only, like a new tree branch, without pieces of bone coming loose. This is called a greenwood fracture (= an incomplete bone fracture).

How to recognize them?

After a fall, your child may have an injured limb that is clearly swollen or deformed and painful. He probably has a broken bone. The indications for a fracture are as follows:

  • displaced or bent bone;
  • swelling at the site of the lesion;
  • clearly defined place where the child is in pain;
  • blue (bruises) on the skin or in nearby soft tissues.

The fact that the child is limping or unable to move the limb may also suggest a fracture.

How is the diagnosis made?

If the doctor suspects a fracture, he will order an x-ray (x-ray) of the injured limb. A fracture is characterized by a break in the outer surface of the bone. The x-ray also shows possible complications of the fracture, such as a complete fracture with displacement of the bone.

What can you do ?

A fracture is a very painful injury. Give your child pain reliever quickly, even before the fracture is examined and treated. If you suspect he has a broken arm, it is advisable to have him wear a supportive sling. If you think their leg is broken, stop the child leaning on that leg.

What can your doctor do?

The doctor will immobilize the fractured limb to relieve the pain. An undisplaced fracture of the arm or leg in a child or infant can be treated without having to cast. Often a supportive sling, crutch, splint or shoe adaptation is sufficient. Hospitalization will not be necessary.

If the fracture visibly flexes the bone or deforms the limb, what is called a reduction, i.e. that we will put the bone back in place (the fracture will be reduced). Depending on the type of intervention and the age of the child, the operation is performed under general or local anesthesia. In some cases, the child must be referred to an orthopedist:

  • for highly displaced fractures;
  • in an open fracture where the bone is seen through the skin;
  • for fractures that affect the surface of the joint;
  • for fractures in the middle part of the forearm;
  • for leg and thigh fractures in children over 6 years old;
  • if we suspect child abuse.

All reduced fractures and some non-displaced fractures should be checked after one week; a follow-up x-ray is done again to check if the parts of the bones are put back in their place.

Want to know more?

Source

Foreign clinical practice guide ‘Fractures in children’ (2000), updated on 05.17.2016 and adapted to the Belgian context on 02.11.2019 – ebpracticenet