About Children’s Fracture

It is normal for children to sustain injuries while indulging in physical activities and sports. Each time a fracture occurs, the child’s bone is broken either partially or completely. A child can also sustain either open or closed fracture. When a closed fracture occurs, the child’s skin remains intact despite break in bone. On the other hand, the bone breaks through the skin each time an open fracture occurs.

Causes

The risk of fractures increases as a child grows. Boys are more likely to sustain fractures than girls. Fracture occurs each time a child applies more force on his bone and the bone fails to absorb the additional force. Normally, a child’s bone breaks due to trauma falls or direct blow. Also, both open and closed fracture may occur due to obesity, inadequate calcium intake and poor nutrition. The children with fracture history are more prone to break bones in future. Hence, the cause of fracture differs from child to another.

Symptoms

The signs and symptoms of fracture vary from one child to another. However, the common symptoms of bone fracture are deformity in the injured area, pain or swelling in the affected area, inability to move or use the injured area normally, and redness/bruising in the injured area. Hence, the parents can easily detect children’s fracture by observing the injured area.

Diagnosis

The parents must contact an orthopaedic as soon as they see the symptoms of bone fracture. The must take the child to a skilled orthopaedic for diagnosis and treatment. The physician will perform X-ray to identify the exact injured area and assess the severity and causes of the fracture. But the parents must take the child to a skilled orthopaedic for treatment without any delay.

Treatment

The skilled orthopaedic always treat fracture according to its cause, symptoms, and severity. They normally treat fractured hands, fingers or wrist with casting or splitting. But they perform surgery to reset the fractured bone if the symptoms are severe. Sometimes the orthopaedics reset the fractured bone by using metal plates, rods, screws or pins. Hence, each treatment for fracture aims to heal the bone through proper positioning.

Recovery

The recovery period of a child’s fracture depends on the severity of symptoms and treatment. Most fractures heal within a period of one month. But sometimes healing period extends if the fracture is severe. Likewise, the child will require additional time to recover if his bone is repositioned or remodelled with surgery. The parents must get the fracture diagnosed and treated without any delay to make the treatment successful and effective.

Case 1

I got a call from emergency department for a girl with suspected elbow fracture. I rushed to the emergency. On clinical examination I found that there was no radial artery pulsation on the injured left elbow and there was also lack of finger movement on that hand (suspected nerve injury). X-ray showed a very bad type (severely displaced) supracondylar fracture humerus.

There were all bad things together – fracture , suspected artery and nerve injury. I arranged for an emergency surgery with vascular surgeon. When I attempted manipulation of the fracture under X-ray machine (Carm), I found it very unstable. With my experience and knowledge I quickly finished the operation without any scar (did CRIF). Post Operative X-ray picture was not 100% perfect from common people’s point of view, but it was definitely acceptable by standard guidelines. I also needed to finish the operation quickly with minimal manipulation to avoid stiffness from such a bad fracture.

Pulse returned after fixation and as result there was no need for vascular surgery. I counselled the parents to wait for self recovery of the nerve injury as per guidelines. After 2 months, the girl came to my clinic with full elbow movement and nerve injury recovery without any deformity or scar of the surgery.