Pediatric injuries and fractures are injuries to a child's bones, joints and ligaments caused by falls, play or accidents. Children's bones are still growing and contain growth areas, so an injury needs assessment by a surgeon who treats pediatric orthopedic conditions.
Note: If a limb looks clearly deformed, there is an open wound, numbness, or the child will not use the limb, seek urgent medical care. Do not try to put the bone back yourself.
Symptoms
- Severe pain and crying when the limb is touched or moved
- Swelling and bruising
- The child refuses to use a hand or stand on a foot
- A change in the shape of the limb
- A sudden limp after a fall
- Pain that stays in one spot after a seemingly minor injury
Causes
- Falls from a height or during play and running
- Sports injuries
- Accidents at home or on the road
- Falling onto an outstretched hand
- Repeated strain in some sporting activities
- Weak bone due to a medical condition, which is less common
Diagnosis
The doctor asks how the injury happened, then examines the limb gently. X-rays are requested to show whether there is a fracture, where it is and how it relates to the growth area.
A child may struggle to describe the pain, so the doctor relies a lot on the clinical examination and what parents have noticed. Children's fractures differ from adult fractures; see the page on pediatric fractures.
Treatment options
Non-surgical treatment
Many fractures and injuries in children are treated without surgery, because children's bones have a strong capacity to heal and grow. The doctor decides the approach after assessment.
As general first aid: keep the limb in the position you found it, avoid moving it unnecessarily, apply a cold pack wrapped in a cloth, and take the child to a doctor. Do not try to straighten the bone or put it back yourself.
- Holding the limb still with a splint or cast
- Rest and limiting movement
- Follow-up X-rays to check the bone position
- Physiotherapy when needed
Surgical treatment
Surgery may be needed if the fracture is badly displaced, involves a growth area or joint, is open, or does not hold in a cast. The surgeon uses fixation methods that take the child's growing bone into account, and explains the plan to parents after assessment.
Recovery and rehabilitation
Recovery time varies from child to child and is set by the surgeon after assessment. Regular follow-up matters because injuries near growth areas can affect how the bone grows later.
- Keeping the cast or splint on and not removing it without advice
- Keeping the cast dry and clean as instructed
- Follow-up X-rays at the times the doctor sets
- A gradual return to play and activity
- Monitoring limb growth at later check-ups
When to see the doctor
Seek medical care promptly if:
- The limb looks clearly deformed
- There is an open wound or visible bone
- There is numbness, coldness or paleness in the fingers or toes
- The child refuses to use the limb or bear weight on it
- The pain is severe or getting worse
- The injury followed a serious accident or a fall from a height