Bone fractures are more common in boys. Signs that a child has a fracture and first aid measures

As children’s bones are growing and more fragile than adults’, fractures are quite common in their case. According to experts’ estimates, bone fractures are three times more common in boys compared to girls, and most fractures occur in the left arm, especially in children between the ages of 10 and 15. These injuries are usually the result of outdoor falls, especially during the spring and summer months. It has also been found that the bones of the wrist, arm and elbow are more prone to fractures compared to other parts of the body.

The severity of a bone fracture varies from minor cracks to complete breaking and displacement of the bone. Common symptoms of fractures include sharp pain, swelling, bruising and, in severe cases, visible deformation of the affected bone or inability to use the limb.

Most fractures heal quickly and do not cause long-term complications. Treatment may involve immobilization with a cast or orthosis, up to surgery in more severe cases, followed by physical rehabilitation to regain full function and mobility.

In the case of a bone fracture, the following symptoms may occur

Older children are usually able to point to the painful spot and describe the incident that caused the injury, which helps to easily detect a broken bone. Conversely, in infants or very young children it may be more difficult to identify. They may cry and begin to avoid using the affected limb without any visible injury.

The following symptoms may occur:

• pain or tenderness at the site of the injury,
• swelling or redness of the skin around the lesion,
• deformation of the affected area,
• refusal to move or use the affected limb.

In rare cases, the injury can cause the skin over the fractured bone to break – a phenomenon known as an open fracture. There may only be a small tear in the skin (and the bone may not be visible sticking out of the wound). If this happens, the child must be taken to the hospital.

In some cases, children may not show any of the signs mentioned above and the fracture may not be visible, even if an injury has occurred.

First aid in case of bone fractures in children

First aid measures for a fracture are aimed at reducing inflammation and relieving pain until the injury is treated by a doctor.

Before taking the child to the hospital, parents can do the following if they suspect a bone fracture:

• Administration of an analgesic (such as paracetamol or ibuprofen);
• Reducing the movement of the affected area, if possible, by applying a splint or a bandage;
• Applying a cold compress to the affected area;
• Elevating the limb to reduce inflammation.

Also, the following situations represent a major medical emergency, in which an ambulance should be called immediately:

• the child has injured his arm and is in severe pain,
• a limb appears deformed,
• the affected limb turns blue or has an unusual color,
• the child has an injury to a limb and there is a large cut where the injury occurred,
• the bone is protruding through the skin or there is a large amount of blood that cannot be stopped.

To diagnose fractures, the specialist will need to examine the child (which may or may not include an X-ray) to determine the type of injury and where it is located.

Treatment of bone fractures in children

In the case of a fracture, movement of the injured area will need to be restricted to allow the bone to heal. Some fractures may require a splint or a partial cast. These devices help support the injured area, facilitating rest and healing while providing pain relief. Usually, splints or partial casts should not be worn for as long as a full cast.

The cast is necessary for three weeks to three months, depending on the type and location of the injury, the doctor being the one who will estimate the exact time.

If the injury caused the bones to move out of place, the specialist will need to move the bones back into the correct position. This procedure is usually performed under sedation or anesthesia in the emergency department or operating room. This type of fracture requires a full cast (encircling the limb) to allow the injury to heal. Full casts should be worn for up to three months, depending on the injury.

What home care entails

The child should be encouraged to rest for the first few days after the fracture and avoid physical activities. Movement of the cast or falls on the affected limb can cause the bone to move out of alignment and may not heal in the correct position.

So, taking care of a fracture at home involves:

• Monitoring the child’s pain level;
• Keeping the affected limb in an elevated position to reduce inflammation;
• Monitoring the condition of the child’s skin and strictly following the doctor’s instructions for the care of the cast or splint;
• Ensuring a healthy diet that includes enough calcium and vitamin D.
• The cast and splint must always remain dry. Otherwise, they can be damaged and the underlying skin can become irritated.

What happens during the healing of broken bones

Broken bones have an amazing ability to heal, especially in children. New bone forms within weeks of the injury, although complete healing may take longer.

There are three stages of bone healing: inflammatory, reparative and remodeling.

Inflammatory stage

When a bone breaks, the body immediately reacts by sending signals to release white blood cells into the affected area. These white blood cells trigger an inflammatory reaction in the injured area, which is manifested by redness, swelling and pain. This reaction tells the body to avoid using the injured part to facilitate the healing process.

In parallel, other cells migrate to the affected area and form a hematoma, that is, a blood clot, around the fractured bone. This hematoma serves as the first step in the formation of a bridge between the fractured bone fragments.

Reparative stage

The reparative stage starts about a week after the injury. The blood clot that formed in the inflammatory stage is replaced by a callus (a type of soft bone tissue). It provides the connection between the fragments of fractured bone, but is not strong enough to allow normal use of the affected area.

Over the next few weeks, the soft callus begins to harden. In about two to six weeks after the fracture, this callus becomes strong enough to allow normal activities to resume.

Remodeling stage

About six weeks after the fracture, the remodeling stage begins. In this phase, normal bone gradually replaces the previously formed hard callus. Anyone who has seen an X-ray of a healing bone has noticed that it is irregularly shaped. However, over the following months, the bone is remodeled to return to its original pre-injury shape and structure.

Factors that can affect bone healing

There are several factors that can influence the bone healing process after a fracture:

• Severity of the fracture: A severe fracture may involve bone fragments that do not line up properly or that do not heal properly;
• Concomitant injuries: the presence of injuries to the muscles, skin and nerves in the area of ​​the fractured bone can affect the ability of the fracture to heal and complicate the recovery process;
• Nutritional deficiencies: lack of certain essential nutrients, such as calcium and vitamin D, can slow the fracture healing process and affect bone strength;
• Pre-existing medical conditions: people with medical conditions such as osteoporosis, osteogenesis imperfecta, diabetes or anemia may have a higher risk of complications in the fracture healing process;
• Use of certain medications: Some medications, such as corticosteroids, can affect bone density and slow the healing process of fractures.

After the cast is removed, the underlying skin may be dry and irritated, so it should be cleaned with warm soapy water, followed by a simple, unscented moisturizer.

During the recovery period after a fracture, children regain their strength by gradually participating in light activities and play. Physiotherapy is usually not needed.

The doctor will give specific recommendations about when and how the child can resume playing sports (about four to six weeks after the cast is removed).

If the child has undergone surgery, contact sports should be completely avoided for a period of two to three months.

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