Broken Bones and Sprains

Musculoskeletal injuries include fractures or dislocations of the bone or joint, sprains, strains, ligament tears, tendon lacerations and nerve or blood vessel damage. A fracture is a break in the bone tissue.

A fracture happens when there is a lot of force placed on a bone which can chip, crack or break the bone. Muscles, blood vessels, nerves, tendons, joints and other organs may be occasionally injured when a fracture happens.

Musculoskeletal System

Bones, joints, tendons, ligaments, muscles, blood vessels and nerves, make up the musculoskeletal system. Children can injure themselves in many ways.

The human skeleton gives form to the body, allows the body to move, protects organs, makes red blood cells, and stores calcium, phosphorus and other body chemicals.

Some fractures are visible, while others can't be seen. Common signs of a fracture include pain, swelling that may be fast or slow, discoloration of the skin, tingling or numbness or the child may be unable to use the injured part. Your child will receive a physical examination. X-rays will be taken of the injured part which will help the doctor determine if a bone is broken.

There are many types of fractures. The doctor will talk to you about the type of fracture that your child has. Additional tests may be ordered, depending on how badly your child is injured.

Treatment for musculoskeletal injuries may involve manipulation (manually regaining correct position), immobilization (maintaining reduction until bone healing occurs) and rehabilitation (regaining normal function of the injured part). The goal is to get your child back to his or her normal activities as quickly as possible.

Once the type of fracture is diagnosed, the injured part is put in its proper place and held there by using a splint, cast or traction. This decreases the pain and keeps surrounding tissue from becoming damaged. It also reduces the chance of serious bleeding and lost circulation to the injured part. Your child will be given pain medication or a muscle relaxant to help him or her relax while the doctor is treating the fracture.

Casts are made of a light weight material called fiberglass and come in several colors that your child may choose from. Some fractures are better taken care of in the operating room. If this is the case, your child will be asleep during the procedure to decrease pain and enable the doctor to treat the break correctly.

Patient is examined by physician

The doctor will usually place the injured part in a splint and then have a cast put on a couple days later. The child with a fracture may go home after casting or may stay in the hospital. The amount of time the child will have to wear the cast will depend on how bad the injury is. Casts are typically worn from four to 12 weeks.

Children who have an injury to their leg may require crutches or a walker to get around. A physical therapist will help your child learn to walk using the crutches or walker. Most children will also be given a wheelchair to use for long distances or if both legs are injured. Your nurse will help you get any equipment your child may need at home.

  • Toes or fingers are cold to touch or look pale or blue
  • Toes or fingers are tingling or numb
  • Toes or fingers become very swollen
  • Pain that does not get better by taking Tylenol or prescribed pain medication

Give your child the medication that he or she took before the injury. Your child may have some pain or soreness at home. Give acetaminophen (also known as Tylenol) for pain. Your child's doctor may give you a prescription for pain medication. Give the pain medicine if the pain does not go away one hour after giving acetaminophen. Follow the directions on the bottle.

After the injury, your child may be tired and irritable. It takes time to heal. Use this time for rest and quiet activities. Tell your child that he or she will feel better soon. Have your child play board games, read or do small craft projects for short periods of time. Infants and toddlers are harder to distract and will be more difficult to confine. Try putting your infant or toddler in a large crib or playpen. Ask family and friends to visit, but for short periods of time, and not at the same time, to minimize activity.

If your child has a cast, it must be kept dry. The cast can be protected during bathing with a large plastic bag. It may be easier for your child to have sponge baths while the cast is on. Your doctor should be called if skin breakdown happens under the edge of the cast, or if the cast becomes too tight or too loose, and if the cast cracks or breaks.

In warm months, Cincinnati Children's offers waterproof casts, which can be a good option for many children with simple fractures. A child or teen may swim and shower in a waterproof cast.

It is very important to teach your child about all types of safety. Your child watches you and will do what you do, so you should also always model proper safety precautions. Your child should learn to wear a helmet when riding a bike, rollerblading or skate boarding. You should also teach your child to always wear a seatbelt when riding in a car. And remember that children 12 years old and younger should always be in age-appropriate restraints in the backseat when the car has a passenger side airbag.

Your nurse will talk to you about when to bring your child back to see the doctor. It will depend on the type and severity of the injury.

Your child may not feel like eating regular foods right away, but it is important that your child eat a balanced diet and drink as much fluid as he or she did before being hurt.

Some children need to use crutches or a wheelchair, and may have special needs at school. While at school the child may need assistance with walking up and down steps or help with carrying books. Having a helper friend from class is something that works at many schools. If home tutoring is needed, your nurse will help. Physical education classes and sports are not allowed until the child has returned for a follow-up visit with the doctor. You will be given a list of activities and sports that are allowed for your child at that time.

If you need to reach the orthopaedic nurse before 4 pm, Monday through Friday, please call 513-636-4567. After 4 pm, and during weekends and holidays, please call 513-636-4200 and ask that the orthopaedic resident on call be paged.


Last Updated 09/2012