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Fractures, or broken bones, are a common childhood injury. Paediatric fractures differ from those experienced by adults due to differences in anatomy and biomechanics and therefore benefit from specialised care.
Paediatric fractures can occur in any bone of the body but are most commonly seen in wrists, arms and elbows. Paediatric fractures include complete fractures, where the parts of the fractured bone are separated and the more common incomplete fractures, such as torus (buckle), greenstick and bowing fractures. When the fracture causes an open wound, this is called a compound fracture. While many fractures can be treated with a splint or cast, some fractures do require surgery. The good news is that paediatric fractures heal more quickly than adult fractures, generally mending in around 4 weeks.
This is the most common fracture among children under age 16, normally resulting from a simple fall on an outstretched hand and extended wrist. It usually involves the end of the bone near the wrist and can involve the growth plate (physis). Often the bones are not too bent and a simple waterproof cast is all that is needed. Angulated or displaced fractures may need a closed reduction under anaesthetic and casting.
These are the most common elbow fractures. Some require only a collar and cuff sling whereas angulated or displaced types are typically treated with closed reduction and percutaneous pinning. They are most common among children aged 5-10 years.
This fracture involves the diaphysis (midsection) of the radius and ulna. It generally results from a fall from height on an extended wrist and elbow. Treatment may involve closed reduction and casting.
The Galeazzi fracture is a fracture of the distal third of the radius with dislocation of the distal radio-ulnar joint. It requires surgery in adults, but children can often be treated with a closed reduction and splinting only. Most Galeazzi fractures will require an orthopaedic consultation.
Pain, tenderness or swelling in the injured limb
Bruising or redness in the injured area
Deformity/lump or bone protrusion
Difficulty moving the injured limb, or keeping still to avoid movement
Fractures are most commonly diagnosed using an x-ray, in some cases a CT or MRI may be required. Fractures are usually treated with a splint or plaster cast. This reduces movement and allows the bones to mend. Modern casts are lightweight and waterproof and even available in a range of colours.
Surgery may be required in some cases. Pain relief, such as paracetamol, may be needed.
Do NOT let water seep inside the cast or make it wet.
Wash the surrounding area of your cast carefully, checking for soreness or redness
Do not poke or push anything down your cast as you could break the skin and cause an infection Check daily for any cracks, breaks or weak areas in the cast
Report if the cast is rubbing and if the cast is too tight or if the fingers & toes swells up.
To promote circulation please keep all fingers and toes moving regularly – move all joints that are not enclosed in the cast