Pediatric Orthopedics is its own specialty because children have bones that are different from adult bones, with types of fractures seen mostly in young bones. Treatment of broken bones in children is also different from the way we treat broken bones in adults. Here is a look at the factors involved in bone fractures and treatment in children.
Broken Bones Heal Best in Kids
Children's bones have an amazing capacity for healing. The younger the child, the higher the healing capacity. In young people, a fracture of the femur (thigh bone) will heal easily in a large cast called a hip spica. In adults, femur fractures almost always require surgery to realign and stabilize the bone.
Healing time in children is usually measured in weeks, whereas in adults most fractures take months for healing. This ability to heal allows surgeons to treat children differently, and more often without surgery.
Growth Plates Matter
Children's bones contain growth plates where new bone cells are quickly dividing. The presence of growth plates is an important consideration as a fracture in or around the growth plate can have significant long-term effects. Because of this, children are watched closely by their doctor as they heal.
Treatment of growth plate injuries should be done by a doctor who is familiar with the various methods of growth plate fracture treatment to help you determine which option is best. Treatments range from a simple cast to surgical correction.
Bones May Bend, and Not Break
Children's bones are more flexible and tend to bend more without breaking. This explains greenstick fractures and buckle fractures, which are injuries seen almost exclusively in the pediatric population. Greenstick fractures occur when the bone breaks on one side, like bending a fresh tree branch, but it stays intact on the bent side. A buckle fracture occurs when the bone buckles on one side, but it is not separated.
Common Fractures in Children
Forearm Fractures: More than 40% of childhood fractures are in the forearm - the radius and ulna bones between the elbow and the wrist. Falling while playing onto an outstretched arm is the usual cause. Both of the bones have growth plates at their ends, so there is a concern if the fracture occurs at or across one as this can affect how the bone grows and matures. Quick medical attention is needed before healing starts, so the bone is set properly.
Ankle Fractures: This is also a common childhood fracture, most often involving the ends of the tibia and fibula at the ankle. There is a growth plate at the ankle for each bone, and it is an area more prone to fracture as it is a weaker area than the bone shafts. Twisting forces on the ankle are the usual cause, especially in jumping and sideways motions in sports such as basketball.
Elbow Fractures: About 10% of childhood fractures are of the elbow, where the radius, ulna, and humerus bones meet. Fractures can occur in several areas of the elbow with a fall on an outstretched arm or the elbow itself or a blow to the elbow. Protective elbow guards for sports, skateboarding, or cycling can help prevent it.
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