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Broken Bones

The harder kids play, the harder they fall. The fact is, broken bones, or fractures, are common in childhood and often happen when kids are playing or participating in sports.

Most fractures occur in the upper extremities: the wrist, the forearm, and above the elbow. Why? When kids fall, it's a natural instinct for them to throw their hands out in an attempt to stop the fall.

Although many kids will have a broken bone at some point, it can be scary for them and parents alike. Here's the lowdown on what to expect.

How Do I Know if It's Broken?

Falls are a common part of childhood, but not every fall will result in a broken bone. The classic signs of a fracture are pain, swelling, and deformity (which looks like a bump or change in shape of the bone). However, if a break isn't displaced (when the pieces on either side of the break are out of line), it may be harder to tell.

Some telltale signs that a bone is broken are:

  • You or your child heard a snap or a grinding noise during the injury.
  • There's swelling, bruising, or tenderness around the injured part.
  • It's painful for your child to move it, touch it, or press on it; if the leg is injured, it's painful to bear weight on it.
  • The injured part looks deformed. In severe breaks, the broken bone might poke through the skin.

What Do I Do?

If you suspect that your child has a fracture, you should seek medical care immediately.

Do not move your child and call for emergency care if:

  • your child may have seriously injured the head, neck, or back
  • the broken bone comes through the skin. Apply constant pressure with a clean gauze pad or thick cloth, and keep the child lying down until help arrives. Don't wash the wound or push in any part of the bone that's sticking out.

For less serious injuries, try to stabilize the injury as soon as it happens by following these quick steps:

  1. Remove clothing from or around the injured part. Don't force a limb out of the clothing, though. You may need to cut clothing off with scissors to prevent causing your child any unnecessary additional pain.
  2. Apply a cold compress or ice pack wrapped in cloth. Do not apply it directly on the skin.
  3. Place a makeshift splint on the injured part by:
    • keeping the injured limb in the position you find it
    • placing soft padding around the injured part
    • placing something firm (like a board or rolled-up newspapers) next to the injured part, making sure it's long enough to go past the joints above and below the injury
    • keeping the splint in place with first-aid tape
  4. Seek medical care and don't allow the child to eat, in case surgery is needed.

Different Types of Fractures

A doctor might be able to tell whether a bone is broken simply by looking at the injured area. But the doctor will order an X-ray to confirm the fracture and determine what type it is.

Reassure your child that, with a little patience and cooperation, getting an X-ray to look at the broken bone won't take long. Then, he or she will be well on the way to getting a cool — maybe even colorful — cast that every friend can sign.

For little ones who may be scared about getting an X-ray, it can help to explain the process like this: "X-rays don't hurt. Doctors use a special machine to take a picture to look at the inside of your body. When the picture comes out, it won't look like the ones in your photo album, but doctors know how to look at these pictures to see things like broken bones."

A fracture through the growing part of a child's bone (called the growth plate) may not show up on X-ray. If this type of fracture is suspected, the doctor will treat it even if the X-ray doesn't show a break.

Children's bones are more likely to bend than break completely because they're softer. Fracture types that are more common in kids include:

  • buckle or torus fracture: one side of the bone bends, raising a little buckle, without breaking the other side
  • greenstick fracture: a partial fracture in which one side of the bone is broken and the other side bends (this fracture resembles what would happen if you tried to break a green stick)

Mature bones are more likely to break completely. A stronger force will also result in a complete fracture of younger bones. A complete fracture may be a:

  • closed fracture: a fracture that doesn't break the skin
  • open (or compound) fracture: a fracture in which the ends of the broken bone break through the skin (these have an increased risk of infection)
  • non-displaced fracture: a fracture in which the pieces on either side of the break line up
  • displaced fracture: a fracture in which the pieces on either side of the break are out of line (which might require the doctor to realign the bones or require surgery to make sure the bones are properly aligned before casting)

Other common fracture terms include:

  • hairline fracture: a thin break in the bone
  • single fracture: the bone is broken in one place
  • segmental: the bone is broken in two or more places in the same bone
  • comminuted fracture: the bone is broken into more than two pieces or crushed

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