Children like to challenge themselves, whether on the monkey bars, ice rink, or trampoline. Taking risks is important part of building confidence and skill. But this sense of adventure can sometimes lead to injury, as broken bones are common in children.
About one in five children and adolescents will get a fracture before they turn 20. Note that doctors use the words broken bones and fractures interchangeably. (It’s a misconception that fractures are a certain type of break — the words break and fracture mean the same thing.)
Breaks can mean minor cracks and don’t always need casting. But more serious breaks require casting — and may need surgery.
If you suspect your child has a broken bone, your first thought might be to rush them to the closest emergency department (ED). But you might not need to wait hours in the ED before you receive care.
For a less severe break, you can go to an urgent care center or get an X-ray through your pediatrician or an orthopaedic pediatrician.
To avoid an unnecessary trip to the ED, it’s important to learn how to tell if your child may have a broken bone. You’ll also need to learn to how to tell if the break if major or minor.
How to Know if Your Child Has a Broken Bone
The following are signs of a broken bone.
Your child can’t put weight on a leg, or they are limping. (A toddler might request that you carry them everywhere).
Your child isn’t moving their arm or hand normally. For example, a child may hold a broken arm to their chest. A child with a broken wrist may not pick up objects with the hand.
The area is swollen and bruised.
The joint looks deformed. For example, the knee is facing in a different direction. (This is a sure sign of a break.)
The injury is very painful.
It can sometimes be difficult to tell if a child has a broken bone. Minor swelling and bruising can occur with a sprain as well as a break.
Unsure if your child has sprained or broken a bone? Have an urgent care center or your family doctor examine it promptly.
Is It a Major or Minor Broken Bone?
If you suspect a broken bone, here are some ways to tell if it’s a minor or major break.
How much swelling is there?
The amount of swelling is a good indicator of whether a break is minor or serious. A minor break will only cause a little swelling, while a serious break usually causes severe swelling.
For example, a broken ankle might rapidly grow into the size of grapefruit.
Which bone is affected?
When it comes to injuries to the wrist, hand, shoulder, or collarbone, these are usually minor in children. As long as you don’t see severe swelling or a misshapen joint, you don’t have to rush to the ED. Still, you’ll want a doctor to look at it the same day or the next day.
However, elbow injuries can be serious, even if they don’t look so swollen. (See “Red flags” below.)
Can your child still walk?
Your child’s movements are another way to tell how serious the injury is. With a minor broken bone in the leg or foot, your child will still be able to walk. However, they may limp a bit or complain that it hurts when they walk.
For a serious broken bone in the ankle or leg, your child won’t be able to put weight on the leg.
Red flags for a serious broken bone
In addition to severe swelling, you might notice a joint looks deformed or sits at a wrong angle. Your child may not be able to move or put weight on the affected area without severe pain. These injuries should be addressed in the emergency department.
Elbow injuries can also be serious in children, even when they don’t look very swollen. The most common type of elbow injury in children up to age 10 is a supracondylar humerus fracture. This is a serious injury that requires timely casting and often needs surgery.
With this type of injury, the sharp edge of the broken bone in the elbow can damage nearby blood vessels or tissue.
If your child injures their elbow, watch them closely. If they’re holding it close to their body or not bending it normally after an hour, head to the ED.
What to Do If You Think Your Kid Has a Minor Broken Bone
For minor broken bones, you don’t need to wait in the ED. Instead, ask your pediatrician to refer your child for a same-day X-ray. You could also visit your urgent care center, walk-in injury clinic, or call your local children’s orthopaedic clinic.
At UPMC, we can often fit your child in for a same-day or next-day appointment. At this appointment, we’ll do an X-ray — and apply a cast or brace, if needed.
In the meantime, you can wrap an ice pack or a bag of ice in a cloth or paper towels and put it on the injury. Don’t put ice directly on the injury, as this can damage the skin. Don’t use heat, as this draws more blood to the area, which can increase swelling.
You can also give your child over-the-counter children’s pain medicine, like acetaminophen (Tylenol®) or ibuprofen (Motrin® or Advil®).
What to Do If You Think Your Kid Has a Major Broken Bone
For possibly serious breaks, you’ll want to go to the ED. As with a minor break, you can treat your child with ice and an over-the-counter pain medicine on the way. For severe pain, you can alternate between ibuprofen and acetaminophen every two to three hours.
For an elbow injury, you can make a sling to hold the arm at a comfortable bent position. You can put a long scarf under the arm and then put each end over a shoulder, before tying it behind the neck.
Making Sure a Child’s Broken Bone Heals Properly
Children heal very quickly, much faster than adults. Your child’s bone will likely be healed enough to be out of the cast or brace within a month or two. It may take a little longer to be cleared to return to full activity. I It’s vital you follow the doctor’s instructions and keep follow-up visits to ensure the bone is healing properly.
If your child stresses an injury before it fully heals, it may mean a longer recovery time. If a bone doesn’t heal in the best position, that can limit long-term movement.
If your child is in school or daycare, be sure to let them know about the doctor’s list of do’s and don’ts. Be sure as well to keep some paperwork from the clinic or hospital.
Do your best to ensure your child has a full and speedy recovery – one day this will be a memory, and a story to tell!
Sources
Dr. Sameer Naraanj et al. Epidemiology of Pediatric Fractures Presenting to Emergency Departments in the United States. Journal of Pediatric Orthopedics. Link