If the displacement is mild, no additional intervention is needed besides normal fracture care. This means one portion of the bone has been shifted with regard to the other portion of the bone. These can be more difficult to identify on X-ray since the appearance of an open growth plate on X-ray has some of the same chracteristics as that of a fracture! This is another case where further imaging may be indicated.Ī fracture may be displaced. Sometimes a bone will be fractured through a child’s open growth plate. Even though the bone is buckled, it is still a broken bone and requires the same type of care all broken bones need! This type of fracture is usually readily identified with X-ray. A buckle fracture of the radius is the most common fracture in children. Otherwise, suspect a fracture if your child doesn’t want to use the injured limb, they are unable to walk on it, it swells significantly and/or turns black and blue, the tuning fork test is positive, they complain of pain persisting or worsening the next day, they have had a fracture before and say “this feels just like it” or they are rather stoic by nature and are complaining that this really hurts! Again, when in doubt, err on the side of caution!įractures come in a wide variety, depending on the force that was exerted, the area of bone involved, the direction of the force and other factors such as added height (falling from a ladder) or speed (falling from a bike)! Fractures range from a mild buckle fracture to an open, displaced fracture, see diagrams below. Significant pain that has not at least somewhat improved after a couple hours of ice, elevation and anti-inflammatory medication.Any obvious abnormal angling of the limb (arm, finger, leg or toe).Any open fracture, which is a laceration or other opening of the skin at the site of injury, especially if any bone is visible - this is an emergency!.Things that require immediate evaluation: No one knows your child or the specific circumstances better than you do! So when should you bring your child in for a suspected fracture? Here are some general guidelines but ALWAYS feel free to call your physician or be seen if you are ever in doubt. Broken bones don’t like vibration! But again, this is just an indicator, it is not 100% accurate! If it causes increased pain, it is more likely that the bone is broken. Interestingly enough, one helpful indicator of a broken bone is a tuning fork! Simply place a vibrating tuning fork, handle down, on the injury.I’m sure you’re catching on to this now, False! While swelling and eccymosis are good indicators that a bone may be broken, they are not necessary – some bones may break with little to no swelling or bruising. If it isn’t swollen and black and blue, it isn’t broken.False! We see many tibia fractures that the patient has been walking on prior to coming in for evaluation. If the child can walk on it, it isn’t broken.False! Most patients still have some ability to move the injured area. If the child can bend it, it isn’t broken.There are many ways people try to determine if a bone is broken. As it sounds, a bone contusion is a bruise to the bone itself and may take as long to heal, or sometimes longer, than a fracture! Bone contusions are difficult to detect on X-ray and may need further imaging. A strong, blunt force to the bone may result in a bone contusion rather than a fracture. Stress fractures may be difficult to initially identify with an X-ray as they can be very subtle. However, too much stress on a bone for a prolonged period of time can cause injuries such as stress fractures. This is what we see with weight bearing exercises like walking and running. Some stress or force on bones is healthy as it causes the bone to strengthen. A spectrum exists with regard to force applied to bone. A bone FRACTURE and a BROKEN bone mean the same thing. The answer to this question is not always as straightforward as we would like! First, let’s review some terminology.
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