Musculoskeletal Injuries - in children

A fracture is a break in the bone that occurs when more force is applied to the bone than the bone can withstand. Fractures are also known as broken bones. They can occur anywhere from a simple fall on the playground to more serious accidents. Sports are also a common cause of fractures in kids and teenagers.

Children’s bones grow throughout childhood. This growth potential allows children’s bones to naturally correct some or all of the deformity caused by a fracture. Because children’s bones are growing, they also break in different patterns compared to adult bones.

The signs and symptoms of a fracture include:

pain in the injured limb
swelling, bruising
numbness and tingling
limb or joint looks out of place or the wrong shape
trouble using or moving the injured area in a normal manner

Children's bones are more flexible and have more healing potential than adult bones. This is good news for recovery, but it also means your child should get medical attention as soon as possible to ensure the bone is in the correct position as it heals.

Diagnostic testing for fractures include most often X-rays. Sometimes computed tomography scan (CT scan) is needed.
In rare cases magnetic resonance imaging (MRI) may be of value.

Treatment is based on the type of fracture, its severity, and the child's age. In most cases, fractures in children are treated with a sling, splint/brace, cast, or walking boot. These immobilize the injured bone while it heals.

Reduction

A reduction is a non-surgical procedure to set the bone so it will heal properly. The doctor realigns the broken bone from outside the body and puts the injured limb in a cast or splint. Reductions are usually performed in an emergency department with medications that manage pain and make your child sleepy or sedated so they won’t remember the procedure.

Surgery

Severe or unstable fractures that can’t be set properly with a reduction require surgery. To increase the chances that the bone will heal in the correct position, your child's doctor will decide early in treatment whether to operate.

The child will be under general anesthesia in the operating room and the doctor will set the bone into place. A pin, a nail, screws, or a plate may be used to hold the pieces of bone securely in place while the bone heals.