Orthopedic injuries: Fractures

Children's bones are softer than those of adults, thus childhood fractures are quite different from those occurring in adults. A child's bones may bend more than 45 degrees without breaking; when fractures do occur, they are often hairline, "green-stick" or simple fractures.

SIGNS OF FRACTURES
It is often difficult to tell whether a child's bone is broken. If you suspect a broken bone, treat it accordingly even if it looks normal.

Signs to look for:
• A piece of bone protruding from a wound

• The child is unable to move the injured part.

• Swelling or deformity of the injured limb or body part

• Pain

• Possible signs of shock

HOW TO GIVE FIRST AID FOR FRACTURES
1. Check the child's breathing and pulse. If they are absent, call for emergency help and start CPR.

2. Check for signs of shock. Keep the child lying down and as quiet as possible. Cover to keep warm.

3. If there is bleeding over the suspected fracture, place a clean cloth or hand over the wound and apply gentle pressure to stop the bleeding.

4. Do not move the child unless the child is in danger of further injury where he is lying. If the child must be moved, make a splint to completely immobilize the injured part.

5. Do not allow the child foods or fluids. Fluid or food intake may delay emergency administration of a general anesthetic if surgery is needed.

6. Do not let the child attempt to "test" an arm, leg or other suspected broken bone by putting weight on it.

7. Do not attempt to realign a broken bone yourself. Instead, apply a splint and consult a physician.

HOW TO APPLY A SPLINT
A fracture always should be immobilized by splinting before the child is moved. To do this, you should do the following:

1. Find a rigid object that will serve as a splint. Anything that is straight, including a rolled-up newspaper or towel, wooden boards, a broom handle or a cane, will do. The splint should be longer than the bone and joint you want to support.

2. Splint the limb as it lies. Cover any broken skin with a clean or sterile cloth. Try to pad the hard splint with soft material such as a piece of clothing or blanket.

3. Tie or tape the padded splint to the injured limb. It should fit snugly but should not cut off blood circulation.

4. After the limb has been immobilized, place an icebag over the area of the break. Place it over a towel, not directly on the skin.

5. For a fractured arm or wrist, apply a splint and then use a piece of clothing or cloth to make a sling to support the arm. Tie the sling and arm to the body to completely immobilize it.

6. For a broken ankle or foot, splint the area with a pillow.

7. For a broken collar bone, shoulder or elbow, use a piece of cloth or clothing to fashion a sling to support the arm and collarbone.

HELPFUL TIPS
• See that children's shoes are in good condition and that the laces are tied.

• Make sure that all children wear a protective helmet when bicycling, rollerblading, horseback riding or engaging in other such activities.

• Make sure there are padded, protective surfaces under jungle gyms, balancing bars and other climbing or acrobatic structures.

IMPORTANT
• Fractures are often only detected by X-rays.

• If what you think is a "sprain" remains swollen and painful for more than a day or two, take the child to a doctor to rule out a fracture.

COMMON TYPES OF FRACTURES
• BEND: The bone does not straighten completely after bending, producing deformity.

• BUCKLE FRACTURE: A portion of the bone is raised or bulging because the bone has been compressed.

• GREENSTICK FRACTURE: The bone has been bent beyond its stress limits and has a split on the side that was stressed, such as what happens when breaking a green stick.

• COMPLETE FRACTURE: The bone has broken into separate pieces.

• DISLOCATION FRACTURE: The bone is both broken and dislocated, or jarred, out of its socket.

• COMPOUND FRACTURE: The broken bone protrudes through the skin or into surrounding tissue.

Excerpt from THE DISNEY ENCYCLOPEDIA OF BABY & CHILD CARE, © 1995 DSH Communications, Inc. This material is based on current medical research and, to the best of the editors' knowledge and understanding, is accurate and valid. However the reader should not use information contained in this material to alter a medically prescribed regimen or as a form of self-treatment, without seeking the advice of a licensed physician.