When your Child Needs a Cast

Broken Bones, or fractures, are a common hazard of childhood. And although breaking a bone takes only a split-second fall off the jungle gym or a quick collision on the soccer field, the healing process takes a bit longer.

In most cases, a child who breaks a bone will need a cast. A cast is a big, hard bandage made of fiberglass or plaster that keeps bones in place while they heal. Depending on the age of a child and the type of fracture, a cast can be on for as little as 4 weeks or as long as 10 weeks.

For minor fractures, a splint may be all that is necessary. A splint supports the broken bone on one or two sides and is adjustable, whereas a cast encircles the entire broken area and needs to be removed by the doctor when the bone is healed.

Types of Breaks

Although a doctor may be able to tell whether a bone is broken simply by looking at the injured area, he or she will also order an X-ray to confirm the fracture and determine exactly what type it is.

Common types of fractures in kids include:

• buckle or torus fracture: an incomplete, or partial, fracture in which one side of the bone bends, raising a little buckle, without breaking the other side
• greenstick fracture: another 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)
• closed fracture: a fracture that doesn't break the skin
• open (or compound) fracture: a fracture in which the end of the broken bone breaks 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. This type of break may require applying pressure to the bones when your child is sedated or surgery to make sure the bones are properly aligned before casting.

Most fractures are easily seen on an X-ray. However, fractures through the growth plate (the area of expandable tissue near the ends of long bones in kids and young teens) often do not show up on X-rays. If this type of fracture is suspected, the doctor will treat it even if the X-ray doesn't show a break.