Children's Fractures

Paediatric Fractures

The medical word for ‘break’ is ‘fracture’. It is quite common for children to break bones as they are very active and they regularly fall during play or in sports. Most of the time it’s not a big issue, but fractures can be frightening to the parents as well as the child.

Is it Broken?

For children falling down is a regular occurrence, but not all of them result in a fracture. The common signs of a broken bone are (1) pain, (2) swelling and (3) deformity – a change in the shape of the bone.  Sometimes it is hard to tell because the bony fragments are so well aligned (see picture below).

The bone could be broken if:

You or your child heard a loud snap or crunching noise during the injury.

There is swelling, bruising, or pain around the affected part.
It is too sore for your child to move the affected limb, touch it, or press on it. If the leg is affected, he/she might be unable to walk on it.
In severe breaks, the affected limb can look severely deformed or bone can protrude out of the skin.

What To Do when a Fracture Happens

If you suspect that your child has a fracture, seek medical attention as soon as possible.

If your child has the following, do not move your child and call for an ambulance:

your child may have sustained an injury to the head, neck or back

the broken bone pokes through the skin. Use a clean gauze/thick cloth to apply constant pressure, and keep your child lying down until medical personnel arrive.  Do not try to manipulate the bone back into the wound!

For less serious injuries, stabilising the bone right after the incident will help it significantly:

Remove clothing – you may need to cut the clothing off
Compression with an ice pack or frozen peas wrapped in towel. Do not apply the ice directly on skin!
Use a makeshift splint if possible
Get medical attention ASAP

Different types of Fractures

There are different terminologies that doctors will use to describe the fractures.

[A] Childrens’ bones are softer and more susceptible to bending rather than breaking, and cause incomplete fractures (fractures that goes partially through the bone). This would include:

Buckle / torus fracture: one side of the bone bends, causing a little bulge, without breaking the other side.
Greenstick fracture: a partial fracture where one side is broken and the other side bends.

Slightly older kids are more likely to completely break their bones. Complete fractures can be:

Closed fracture: a fracture that doesn’t break the skin
Open (or compound) fracture: a fracture with the end of the bone going through the skin (with an increased risk of infection).
Non-displaced fracture: a fracture where the pieces of the bone on either side line-up.
Displaced fracture: a fracture in which the pieces on either side of the break are out of line; which may either require surgery or manipulation and placed into cast.
A fracture through the growing part of the child’s bone (the growth plate) may not show up on xray, but will be treated as if there is a fracture.

Other common fractures are

Segmental: the bone is broken in 2 or more places in the same bone
Comminuted fracture: the bone is broken in 2 or more places or it is crushed.

Getting a Splint or a Cast

A splint is sometimes used to keep the bones from moving after an injury. There is normally a layer of soft cotton

Casts for broken bones are either made of plaster of Paris (POP) or fibreglass (synthetic material). Even though a child may think the cast is a cool thing to have, it can be scary to get one especially if the child is in pain. The POP casts are not waterproof but the fibreglass ones are, although the linings under the cast are not. So it is important to keep the cast away from water at all times.

When will the bones heal

Fractures heal at different rates, depending on the child’s age and the type and location of the fractures. Most fractures in young children would take 3 weeks to heal, but the same kind of fractures in teenagers would take 6 weeks.

It is important to not let your child to start playing sports or games for the affected limb until the doctor said it is safe to do so.

Last reviewed: September 2016

Peer-Reviewed by: Shahril Shaarani

IITOS does not endorse any treatments, procedures, products, or physicians referenced herein. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon, or locate one in your area through the “Find a Consultant”section on this website.