There are many classifications of bone fractures. Treatment can range from simple splinting or casting to operations with metal pins or plates, depending on the type of fracture your child has.
Types of Fractures
Open vs. Closed Fractures
Fractures that happen without tearing the skin are called closed. If there is opening in the skin, the fracture is called open. Open fractures are more likely to have infection. Open fractures must be cleaned thoroughly, and your child must take antibiotic medication.
Shaft, Growth Plate and Joint Fractures
If fractures are in the middle of the bone and do not involve a joint, they are called shaft fractures. In children, unlike adults, there are growth centers in the flared end of the bones. Fractures in these growth areas are called Salter fractures and can make children's fractures more difficult to treat than a similar fracture in an adult.
Only 2% of growth plate fractures develop a growth arrest which can lead to a short or crooked bone. Severe growth plate fractures may need to be followed for 6-12 months after healing to ensure proper growth.
If the fracture crosses into the joint, the fracture is intra-articular. Intra-articular fractures, if small, can be treated with temporary splinting and then gentle motion exercises. Larger fractures may require reconstruction in the operating room. Whenever the joint is involved, there is a possible loss of motion in the joint. There is also the possibility of arthritis. The best results happen when all therapy exercises are done properly and regularly.
Simple vs. Comminuted Fractures
When a clean fracture line can be found with two bone fragments, the fracture is described as a simple fracture. If there are multiple lines of fracture with more than three pieces of bone, the fracture is called comminuted.
Comminuted fractures are more difficult to reduce (put back into place) than simple fractures. Occasionally, even simple fractures in bad spots can be difficult to reduce.
Stable vs. Unstable Fractures
Stable fractures stay put after they have been reduced. In this case, a cast or splint will continue to hold the fracture until it has time to heal. Unstable fractures keep returning to their fractured position after reduction and require some type of hardware (pins, plates, wires, or screws) to keep them in place.
Splints/Casts
Casts and thermoplastic splints are the most common form of treatment to protect finger fractures during healing. Most athletes can continue with contact sports if properly protected during healing.
