Pediatric fractures are breaks in a child's bones, and they differ from adult fractures because a child's bones are still growing and contain growth areas. For this reason they need assessment by a surgeon who treats pediatric orthopedic conditions.
Note: If you suspect a fracture in a child, keep the limb still, do not move it unnecessarily and do not try to put the bone back yourself. Seek urgent care if there is an open wound, clear deformity or numbness.
Symptoms
- Crying and pain when the limb is touched or moved
- Swelling and bruising
- The child refuses to use the limb or stand on it
- A change in the shape of the limb
- A sudden limp after a fall
- Pain in one specific spot even if the injury looks minor
Causes
- Falls during play or from high places
- Accidents at home or on the road
- Sports injuries
- Falling onto an outstretched hand
- A severe twist or a direct blow
- Less common conditions that weaken the bone
Diagnosis
The doctor asks how the injury happened and examines the limb gently, then requests X-rays to show the fracture, its location and how it relates to the growth area. A child may find it hard to describe the pain, so the doctor takes parents' observations seriously.
Children's bones are more flexible and can break in patterns different from adult bones, and a fracture does not always show clearly on the first X-ray. For more, see pediatric injuries and fractures.
Treatment options
Non-surgical treatment
As general first aid: keep the limb still in the position you found it, do not move it unnecessarily, apply a cold pack wrapped in a cloth, comfort your child and take them to a doctor. Do not try to put the bone back yourself.
Many children's fractures are treated with a cast or splint, because children's bones can heal and remodel as they grow.
- A cast or splint to hold the bone
- Rest and limiting movement
- Follow-up X-rays to check the bone position
- Physiotherapy when needed
Surgical treatment
Surgery may be considered if the fracture is badly displaced, unstable or open, or involves the growth area or a joint. The surgeon chooses a fixation method that takes bone growth 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 a fracture near a growth area can affect how the bone grows, so follow-up may continue as the child grows.
- Keeping the cast or splint on and not removing it without advice
- Keeping the cast clean and dry as instructed
- Follow-up X-rays at the times the doctor sets
- A gradual return to play and activities
- 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 bone showing
- There is numbness, paleness or coldness in the fingers or toes
- The child refuses to use the limb
- Pain or swelling increases, especially while in a cast
- The injury followed a serious accident or a fall from a height