What parents should know about fractures in kids

When kids play, falls and bumps are bound to happen. But when that bump leads to a broken bone, it can be scary for any parent. The good news is broken bones in children often heal faster than in adults, and many don’t even need surgery. Still, knowing what to look for and when to seek care is important.

Experts from the Division of Orthopedic Surgery and Sports Medicine at Ann & Robert H. Lurie Children’s Hospital of Chicago say they treat thousands of children every year for bone injuries. Dr. Matthew Bueche and Dr. Brian Lindell, who care for patients at Lurie Children’s fracture clinic in Naperville, shared what parents should know.

Most broken bones in children happen after a fall.

“Fractures are less common in babies, but once a child starts walking and climbing, they’re more at risk,” said Bueche. The most common type of broken bone in kids is a wrist fracture, especially the distal radius — the large bone in the forearm near the wrist. Other common spots include the elbow, forearm and shinbone.

Children can break bones in many ways, especially during active play.

“We see injuries from bikes, scooters, skateboards, trampolines and playground equipment like monkey bars,” said Lindell. “The higher and faster a child goes, the greater the chance of injury if they fall.” Wearing helmets, wrist guards, and other safety gear can help lower the risk of a break but won’t prevent all injuries.

Not all breaks are the same. “Children’s bones are softer and bend more easily than adults’ bones,” Bueche explained. “Because of this, kids often get incomplete fractures, also known as buckle, greenstick or hairline fractures.” These injuries happen when the bone bends or cracks but doesn’t break all the way through. In many cases, the thick tissue around the bone, called the periosteum, helps keep the bone stable while it heals.

Sometimes it’s hard to know if a child has a broken bone or just a sprain. “You can’t always tell just by looking,” said Dr. Lindell. “Both can cause swelling and bruising. Usually, if it’s a sprain, the soft tissue like ligaments will hurt more to the touch. If it’s a fracture, the bone itself is more painful.” If there’s doubt, doctors may use an X-ray to check for a break.

If a child has a lot of pain, swelling, or won’t use a limb, it’s best to get it checked out. “Go to the emergency room if there’s obvious deformity, like a limb that looks bent or twisted,” said Bueche. “For severe pain or trouble moving the area, urgent care or an immediate care center with X-ray can help.”

For mild pain without swelling or deformity, parents can wait a little while to see how the child feels. But if the pain continues or the child refuses to use the limb, follow up with a doctor.

Children's bones are still growing and many fractures happen near the growth plates — areas of developing tissue at the ends of bones.

“Growth plate injuries need to be watched closely, sometimes for up to two years,” said Dr. Lindell. “Even after the bone heals, problems can show up later if the growth plate is affected.”

This is one reason seeing a pediatric orthopedic specialist is important. These doctors are trained to treat growing bones and use special tools designed for kids.

Most fractures in children can be treated without surgery. Casts, walking boots, or removable braces are common.

“Many minor fractures don’t even need a cast,” said Dr. Bueche. “A removable brace or boot can be just as effective and easier for parents and kids.” Still, more serious fractures — especially those that involve joints or growth plates — may require surgery.

The good news is that children’s bones heal faster than adults’. “Their thicker periosteum and growing bones help them recover faster,” said Dr. Lindell. “Even if a bone heals slightly crooked, it can often straighten over time as the child grows.”

But not every fracture is the same. That’s why expert care is important, especially if the break is near a joint or growth plate.

Lurie Children’s sees more than 41,000 young patients each year for orthopedic conditions. Their team offers specialized care just for kids, which can make a big difference in healing and long-term health. “Pediatric orthopedic surgeons are trained to treat children’s unique injuries,” said Bueche. “We understand how kids’ bodies grow and heal, and we have the right tools and experience to treat them safely.”

• Children's health is a continuing series. This column was provided by Ann & Robert H. Lurie Children's Hospital of Chicago.