Paediatric fractures, or broken bones, are a common problem in children, affecting more than 1 million kids each year. Whether it’s from a fall at the playground or a sports accident, children are prone to bone injuries. However, unlike adults, children's bones are still growing, which means their fractures are often different from those in adults.

This blog provides a complete guide to paediatric fractures, explaining the signs to watch for, ways to prevent injuries, and what to do if a fracture happens.

Paediatric Fractures: Brief Overview
Causes of Fracture in Children
Symptoms of Fracture in Children
How to Manage a Child’s Fracture
Preventing Fractures in Children
Whom to Consult
Frequently Asked Questions

Paediatric Fractures: Brief Overview

Paediatric fractures occur when a child’s bone breaks or cracks, often due to falls, accidents, or sports injuries. Since children's bones are still growing, they are more prone to fractures than adults. Their bones are more flexible and contain growth plates, making them susceptible to specific types of fractures, such as greenstick fractures, where the bone bends without fully breaking.

Paediatric fractures can be classified into two types: non-displaced, where the bone stays in its original position, and displaced, where the bone shifts out of place. Displaced fractures need immediate medical attention to prevent complications.

Fractures can happen anywhere in the body, but the arms and legs are most commonly affected. Bone healing in children is generally faster than adult, but it's important that they are properly aligned during healing to avoid long-term issues.

Causes of Fracture in Children

Children are active and often prone to accidents, but certain situations increase the risk of fractures. Here are some common causes:

Falls: Falling is one of the leading causes of fractures in children. Whether it’s from playground equipment, furniture, stairs, or simply running and tripping, falls can result in fractures, particularly in the arms and wrists, as children often instinctively try to break their fall with their hands.
Sports Injuries: Playing sports, especially contact sports like football, basketball, or soccer can result in fractures. The impact from collisions or falls during sports activities often affects the legs and arms causing bone breaks or cracks.
Accidents: Fractures can also occur during accidents, such as falling off a bicycle or being involved in a car crash. In bicycle accidents, the absence of protective gear like helmets and elbow pads can lead to fractures. Motor vehicle accidents are another common cause often leading to severe fractures due to the intensity of the impact.
Medical Conditions: Certain medical conditions make bones more fragile and prone to breaking. For instance, osteogenesis imperfecta, also known as brittle bone disease weakens bones making them highly susceptible to fractures, even from minor incidents. Another condition, rickets, which is caused by a vitamin D deficiency leads to soft and weak bones that can easily fracture.
Overuse Injuries: Repetitive stress on a particular bone or joint often seen in children who play sports or engage in physical activities frequently can lead to stress fractures. These small cracks in the bone develop gradually over time due to overuse or repetitive impact.
Child Abuse: In some unfortunate cases, fractures in children are the result of physical abuse. Unexplained fractures, especially those that occur repeatedly, should always be thoroughly investigated to rule out abuse and ensure the child’s safety.

Symptoms of Fracture in Children

Identifying a fracture in a child can be tricky, especially in younger kids who may not express their pain clearly. Common symptoms include:

Pain and tenderness: The child may complain of severe pain at the injury site, especially when touched or moved.
Swelling: Fractures often lead to swelling around the affected area, sometimes accompanied by bruising.
Deformity: In severe cases, the injured limb may appear deformed, bent, or out of alignment.
Limited movement: The child may avoid using the injured limb or may have difficulty moving it normally.
Irritability or crying: Very young children who can't explain their pain may become unusually fussy or cry more than usual.

How to Manage a Child’s Fracture

Treating fractures in children depends on the type and severity of the break. Here’s a step-by-step guide to managing a child’s fracture:

Initial Care: If you suspect a fracture, immobilise the area and apply ice to reduce swelling. Avoid moving the injured limb unnecessarily.
Medical Attention: Seek medical help immediately. In some cases, calling an ambulance may be necessary, especially if there is a visible deformity or severe pain.
Diagnosis: A doctor will usually perform an X-ray or other imaging tests to confirm the fracture and assess its severity.
Treatment: Depending on the type of fracture, treatment may involve:

Casting or Splinting: For simple fractures, a cast or splint may be used to immobilise the bone and allow it to heal.
Surgery: In more severe cases, surgery may be required to realign the bones, especially if the fracture involves the growth plate.
Physical Therapy: Once the cast is removed, physical therapy may be recommended to restore movement and strength in the affected limb.

Follow-up Care: Regular follow-up appointments are essential to ensure the bone is healing properly and to prevent any long-term issues.

Preventing Fractures in Children

Preventing fractures in children requires a combination of supervision, education, and safety measures. While not all fractures can be prevented, taking certain precautions mentioned below can reduce the risk:

Ensure your child wears proper safety gear, such as helmets and knee pads, during sports and playtime.
Remove tripping hazards, install safety gates for toddlers, and make sure playground equipment is well-maintained. Ensure that the child’s surroundings are safe.
Secure furniture and heavy objects to prevent tip-overs.
Teach your child proper falling techniques such as rolling and absorbing the impact.

Encourage a balanced diet rich in calcium and vitamin D to promote strong bone growth.

Whom to Consult

If you suspect your child has a fracture, seek immediate medical attention. Consult with a paediatric orthopaedic specialist at Narayana Health, a leading healthcare provider for children's orthopaedic care. We ensure every child receives the best possible treatment.

Delaying treatment or seeking care from a non-specialist could result in improper healing and long-term complications, especially if the fracture involves a growth plate.

So, don’t delay! Contact us today to schedule an appointment with our paediatric orthopaedic specialists for expert care and a prompt recovery support.

Frequently Asked Questions

Q. What is the most common paediatric fracture?
A. The most common paediatric fracture is the distal radius fracture, which occurs in the wrist. It usually happens when a child falls onto an outstretched hand.

Q. What are the 5 most common causes of fractures for kids?
A. The top five causes of fractures in children are:

Falls from playground equipment
Sports injuries
Accidents
Overuse injuries
Medical conditions

Q. What are the most common paediatric arm fractures?
A. The most common arm fractures in children include:

Distal radius fracture (wrist)
Supracondylar fracture (elbow)
Forearm fractures (radius and ulna)

Q. Which type of fracture is common in preschool children?
A. Greenstick fractures are common in preschool children. These fractures occur because their bones are softer and more flexible, causing the bone to bend and partially break.

Q. What is the most common paediatric femur fracture?
A. The most common paediatric femur fracture is a shaft fracture, where the long, central part of the thigh bone breaks. This type of injury usually results from a high-impact trauma, such as a fall or car accident.

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Ref Links

https://www.nationwidechildrens.org/conditions/health-library/fractures-in-children.
https://www.hopkinsmedicine.org/health/conditions-and-diseases/fractures-in-children.
https://www.childrenshospital.org/conditions/fractures.