Pediatric Fractures

Bone Fractures means broken bones. Many a time’s parents ask me does my child have broken bone or fracture and just to clarify they are the same thing. Your child can have small breaks or have larger ones which may need surgery. The incidence of pediatric fractures has increased as our kids are more athletic and sportier.

A child’s bone is softer than adult bones and is more prone to bend rather than break. Fractures occur after a child falls or a significant force is applied to their bones. They show the various special types of injuries compared to their adult counterparts. These may include buckle type fracture, greenstick type of fracture, plastic deformation of bones, or fracture around and involving the growth plate. The growth plate is located near the ends of the bones and is made up of special cartilage. The growth plate is the weakest part and is prone to injuries.

The most common ones we see are ones involving the wrist, forearm, and elbow fractures. They can also have injury around the knee, ankle, and sometimes around the shin bone or thigh bone.

When your child is hurt or has a broken bone, you need to understand that most injuries in children are not very bad unless a visible deformity or wounds are seen or there is an injury to nerves or vessels. In such cases, they should be rushed into the casualty. In general, after an injury you need to make the child rest the affected area, ice, elevate the body part, and give analgesics. The sooner these things are done the better for the child. Temporary splints can be given for transportation. Never massage the affected area. Take your child to be seen by a specialist pediatric orthopedist who has experience in treating pediatric bones as children’s bones have special injuries, which if not picked up and treated well can cause problems with growth or lead to deformity.

Once your child has been seen, they will require x-rays of the injured area and at times advanced imaging like MRI, CT to help diagnose specific fractures. Depending on the injury it may be treated with a splint, cast, or surgery.

An experienced pediatric orthopedic surgeon, will give you advice regarding the most appropriate treatment as well as advice regarding long term outcomes and return to play following the injury.

I am always asked by parents about the things they can do to reduce the risk of fractures and I like to think of it as a three-prong attack.

1. Good nutrition – Children are growing and if you want them to grow long strong bones resistant to injury then they need calcium, Vitamin D in their diet every day.
2. Exercise – 30-60 minutes of exercise every day. Muscles are attached to our bones and as the muscle pulls the bone, the bone reacts and forms even stronger bone. So, exercise is a very important part.
3. Good safety – Children are going to play and tend to fall. We know that, but there are some high-risk areas we need to be careful such as in schools and play areas. One common injury we saw is foot entrapment at home or on a slide. So, make sure the feet are well tucked in while going down. Elementary age children get hurt on playgrounds namely on monkey bars and swings.

Older kids mostly get sports-related injuries. We tend to recommend avoiding overspecialization in one sport as there is a risk of overuse injuries. Now the newest high-risk place is trampolines, they are great fun, but can be dangerous.

We at SRCC Children’s Hospital, managed by Narayana Health, give specialized care in all aspects of pediatric injuries, we have around the clock team of doctors and nurses who treat children of all ages all the time to take care of your child and make you and your child comfortable during this whole process.

Dr. Avi Shah, Consultant Pediatric Orthopedic Surgeon – Orthopaedics | SRCC Children’s Hospital, Mumbai