broken bones 101

Broken Bones 101

Whether you have toddlers or teens, you are familiar with the fact that kids regularly test the law of gravity. So you probably won’t be surprised to hear that broken bones are the number one injury we see in the emergency room. Here are some tips about what to do – and not do – when faced with a fracture:

1. How do I know if my child has a broken bone versus a really bad sprain?
Sound: Fractures typically make a cracking noise, while a sprain will sound like popping or grinding. Many times, an x-ray and/or exam is the only way to tell the difference. Appearance: A broken limb may look lumpy, crooked, or be unable to move normally, sprains generally get red and swollen without deformity. Pain level: In most kids, the pain from a break will be severe. I’ve heard parents say that just the look on their child’s face told them the injury was different.

2. If the bone is sticking through the skin, should I try to stick it back in?
Never. Do apply gentle pressure with a clean cloth to stop any bleeding, and get medical attention immediately. Also, never wash a protruding bone, or the area around the injury, even if it is dirty.

3. Should I splint a suspected broken bone before going to the doctor?
Yes. You can help prevent further injury by keeping the fracture still. Use a stiff material to secure the limb in its exact position – newspapers, yardsticks, cardboard all work – just make sure the splint extends past the break. If you suspect a broken neck or back, NEVER move your child. Call 911.

4. Will all breaks require a cast?
Not every fracture (toes, ribs), but many will. Luckily, the casts that you might have grown up with (stinky, hot, itchy, heavy) have gotten an upgrade, and I don’t just mean the neon colors. Today, many fractures can be wrapped in a lighter-weight, water resistant fiberglass that kids seem to find, literally, much cooler.

5. Is a hairline fracture really a broken bone?
It’s more like a fracture waiting to happen. Also known as stress fractures, these small breaks are common in the leg bones and feet of young athletes. Hairline fractures generally won’t show up in x-rays, so if you have an athletic child complaining of recurring pain, particularly after an activity, a visit to a sports medicine or orthopaedic doctor could help. Treatment can range from rest to soft casts – but the primary goal is to avoid a tiny crack turning into a full-fledged break. Some children can have incomplete fractures call buckle fractures, typically at the wrist, that will not produce a lot of pain and may be treated with splinting rather than casts.

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Kevin Klingele, MD
Kevin E. Klingele, MD, is the Chief of Orthopaedic Surgery, Director, Nationwide Children's Fellowship program, Surgical Director of Sports Medicine, Nationwide Children's Hospital and Clinical Assistant Professor of Orthopaedic Surgery at The Ohio State University College of Medicine. He received his medical degree from The Ohio State University. After completing residency at Indiana University he completed a fellowship in Pediatric Orthopaedic Surgery at Boston Children's Hospital. Primary clinical interests include adolescent and children's sports medicine, pediatric trauma, hip preservation and reconstruction including periacetabular osteotomy and surgical hip dislocation techniques, and lower extremity reconstruction. He is a Member of the American Academy of Orthopaedic Surgeons, Columbus Orthopaedic Society, Ohio Orthopaedic Society, Central Ohio Pediatric Association, Pediatric Orthopaedic Society of North America, International Perthes Study Group and Gillespie Pediatric Orthopaedic Study Group.

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