When you hear that your child has a fracture it can be a real concern. You may not be sure what a fracture is, how long it will take to heal and whether there are any long-term things to worry about. Depending on the situation there may also be other considerations like “how will we cope when my child cannot get around as normal because they are in crutches?”
In the next month’s Kids Bone Matters I hope to help you understand a little more about fractures so that you as a parent will be more confident in understanding what is happening with your child’s bones as they heal.
A fracture is a break in the bone. The line of the break can go part of the way or all the way through the bone.
There are many different types of fracture in adults and children. But because the bone structure of children is still not fully developed there are a number of fractures that only happen or mostly happen in children.
Some of these fractures are
- Greenstick fracture: a break on one side of the bone only
- Buckle or torus fracture: an outward bend on one side of the bone without breaking the other side
- Avulsion fracture: when a tendon or ligament pulls off of a tiny piece of bone
- Growth plate fracture: a break in the area of a child or teen’s growing bone
The signs and symptoms of a fracture will depend on which bone and what type of fracture. In general, there is pain. There may also be swelling and bruising. Your child may not be happy to move the injured area or use it. The area might not be it’s normal shape
A fracture is diagnosed by taking an x-ray. This will help to see where the fractures is, what type it is and the position of the bones in relation to each other. Once this has happened the person treating your child can begin to plan what should be the management for your child.
Deciding the treatment for you child will depend on the place and severity of the fracture. With all fractures you want the fracture to be lined up enough and to be held in that position while it heals. Most fractures don’t need help to heal, they just need to be helped to stay in a good position as they heal. In children fractures don’t need to be very lined up most of the time because children’s bones can reshape as they heal.
Most fractures are treated without surgery. They are often put into a cast or a splint. This helps the bones to stay still as the fracture heals up. Sometimes the bones are not lined up as well as is needed (they are displaced). In this case the bones need to be realigned. This is called a reduction.
A reduction of the displaced bones can be closed (without a cut to the skin) or open (with a cut to the skin and seeing the bones). A closed reduction can happen in the accident and emergency or in the operating theatre. An open reduction will need a general anaesthetic and needs to be done in an operating theatre.
How long a fracture takes to heal depends on the age of your child, the type and position of the fracture. In a baby a broken thigh bone can heal in two to three weeks, but I’m a teenager that can take 2 -3 months. Broken bones have a great capacity for healing and almost all childhood fractures do heal and will heal much faster than in an adult.