Fractures

Types of fractures

Children can get several types of fractures. These include the following:

Greenstick fracture: this is when a bone is bent rather than broken. Greenstick fractures are common in young children, whose bones are softer than adults’ bones.
Undisplaced fracture: this is when the bone is cracked but still in the correct position for healing.
Open or compound fracture: this is where the bone ends don’t line up and one end of the broken bone pokes through the skin. This kind of fracture can easily get infected.

Fracture symptoms

The area around the fracture is painful and usually gets swollen. Sometimes you can see an obvious lump, or your child’s arm or leg will look unusual.

Your child might hold their arm or leg still because even the slightest movement increases the pain.

Medical help: when to get it for children with fracture symptoms

Your child needs medical attention if you think they have any of the symptoms of a fracture, especially if they’ve had a fall or a big bump.

You should take your child to your GP or go to the nearest hospital emergency department.

Tests for fractures

Doctors will always confirm that your child has a fracture by doing an X-ray. If there’s any doubt, a doctor might send your child for other tests, like a CT scan or bone scan.

Treatment for fractures

If you think your child has a fracture, splint it by resting it on something solid until you can see a doctor. Avoid giving your child food or drink until you’ve seen a doctor, in case your child needs surgery. Your child might also need pain relief like paracetamol or ibuprofen.

Most fractured limbs need to be splinted or put into a plaster cast. This lets the bones grow back together and mend without being disturbed.

In some cases, your child might need surgery.

The healing time depends on the type of fracture and how bad the fracture is. Generally, though, children’s bones mend in around 4 weeks, usually without any complications.

If your child has a fracture of the skull, they’ll need careful medical attention because of the delicate brain tissue underneath.

Caring for a fracture in a cast

After your child has a plaster cast put on, you and your child need to take care to ensure that there are no complications.

What to do

Keep your child’s limb elevated to decrease swelling. This means keeping the arm in a sling, or resting the leg on a stool or pillow while lying down. Keep elevated for 48 hours – this is how long it takes for the plaster to dry completely.
Encourage your child to wiggle the fingers or toes of the affected limb often. This will keep blood flowing.
Go back to your doctor for a check the day after the cast goes on. This is very important – it ensures that swelling hasn’t made the plaster too tight overnight.
If your child is itchy under the plaster cast, tell them to gently tap the outside of the cast. You can also try blowing a hairdryer at the opening of the cast – always on the cool setting.
Check your child’s skin every day for any areas that seem irritated or uncomfortable.

What not to do

Don’t poke anything – for example, a knitting needle – into the cast. This might lead to an increased risk of infection.
Don’t get the plaster cast wet. Use a plastic bag over the cast and seal with tape when your child has a bath.
Don’t use lotions, powders or oils under or around the cast.

When to take your child to your GP or the nearest hospital emergency department

Your child has severe pain.
The cast is damaged.
Your child’s skin feels hot, or looks irritated or inflamed. On children with darker skin, inflamed skin might look brown, purple or grey. On children with lighter skin, inflamed skin might look red.
There’s a bad smell coming from the cast.