Diagnosis of Broken Bones and Sprains
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. To see if a bone is broken, your child will have a physical exam and X-rays taken of the injured part.
There are many types of fractures. The doctor will talk to you about the type of fracture that your child has. More tests may be ordered, depending on how badly your child is injured.
Treatment of Broken Bones and Sprains
Treatment for musculoskeletal injuries may involve reduction (manually putting the bone back in 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 their 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, brace 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 may be given pain medicine or a muscle relaxant to help them 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.
The doctor will usually place the injured part in a splint and then have a cast put on a couple of days later once swelling decreases. 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 helps children learn to walk using the crutches or walker. Most children will get 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.
Call Your Child's Doctor If:
- 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
Medications for Injury
Give your child the medicine they 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 medicine. Give the pain medicine if the pain does not go away one hour after giving acetaminophen. Follow the directions on the bottle.
Your child may feel tired and irritable after the injury. It takes time to heal. Use this time for rest and quiet activities. Tell your child they will feel better soon. Have them play board games, read or do small craft projects for short periods. Infants and toddlers are harder to distract and 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. Protect the cast during bathing with a large plastic bag. It may be easier for your child to have sponge baths while the cast is on. Call your doctor if you notice:
- Skin breakdown under the edge of the cast
- The cast becomes too tight or too loose
- 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.
Prevention of Injury
It is very important to teach your child about all types of safety. Your child watches you and will do what you do, so always model proper safety precautions. Your child should wear a helmet when riding a bike, rollerblading or skate boarding. Teach your child always to wear a seatbelt when riding in a car. And remember to use age-appropriate restraints in the back seat for children 12 years old and younger 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 they did before being hurt.
Activity after Injury Repair
Some children need to use crutches or a wheelchair, and may have special needs at school. While at school, the child may need help with walking up and down steps or 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. We will give you 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, call 513-636-4567. After 4 pm and during weekends and holidays, call 513-636-4200 and ask the operator to page the orthopaedic resident on call.