Editor’s note: Wellness Word is an informational column which is not meant to replace a health care professional’s diagnosis, treatment or medication.
While the anklebone may indeed be connected to the shinbone and similarly the shinbone connected to the thighbone (or so the old song goes), sometimes those bones break.
This is particularly true for children whose bones are very soft and for younger, school-age children; the ligaments are often stronger than the bones themselves. This adds up to a situation where a break in the bone (or fracture to use medical-speak) is more likely than a strain or sprain, especially in younger kids.
The good news is that kids heal really fast. Before we get into more practical advice about how to tell if your child has broken a bone, let’s discuss how fractures typically happen.
Broken bones make up around 9% of injuries that show up to healthcare clinics or hospitals. Falls of some type cause the vast majority of bone breaks. Monkey bars, trampolines, and bounce houses are the biggest offenders. The most common fractures in kids typically involve the forearm but any extremity can be fair game. Fractures of what we call the axial skeleton (skull, spine, pelvis, etc.) are much less common and typically result from more severe trauma.
Unfortunately, the only surefire way to diagnose a fracture is to have your child evaluated by a medical professional. If you’re not sure (or even if you are) of a broken bone, a medical visit is in order.
There are a couple things that should increase suspicion of a fracture. One tip is to grip on either side of where you think the fracture is and attempt to gently squish the two ends of the suspected broken bone together. If this triggers pain or discomfort, suspicion for a fracture is increased.
Another tip is to look for something called “point tenderness”; pain that can be pointed to with one finger. For example if a whole foot hurts vs. one single point on the foot, fracture may be a bit less likely. If there is any confusion or if a broken bone is suspected, seek medical care.
Any fracture where the bone is either breaking the skin, or applying enough pressure to cause what we call “tenting” of the skin, (exactly what it sounds like) needs to be evaluated in your nearest pediatric emergency room.
Barring that, seek care at either your child’s primary care doctor’s office, or a pediatric specific urgent care practice. After a thorough evaluation, a healthcare provider will typically obtain a set of x-rays and either apply a cast or a splint.
For more complicated fractures, a temporary splint is sometimes applied with instructions for follow-up with a pediatric orthopedic doctor in a few days.
An interesting fact is that approximately 20% or more of fractures don’t show up on the initial X-ray. Often this means that we treat it as if there is a fracture or repeat the X-rays at some point. Typically, after a few weeks in a cast or splint, a child will be ready to go.
Fractures often seem like a childhood right of passage. Thankfully, with appropriate and timely attention, most of the time they heal well without any complications down the road.
Corey Fish, MD FAAP 504.963.7963. pacificcrestchildrens.com.