Paediatric Fractures
What are paediatric fractures or children’s fractures?
Paediatric fractures refer to children or adolescents suffering from bone injuries or fractures that require non-invasive treatment. We provide expert fracture management for children, with early rehab, removable casts and optimal care plans to help them recover smoothly. Children’s bones have excellent remodelling and recovery potential, often straightening over months with growth. This unique characteristic among kids allows non-invasive paediatric fracture management whereas surgery would be required in adults. If your child has suffered a limb injury that is not an emergency, but requires prompt medical attention, talk to us about our 6 week post-injury management plan.
Common Paediatric Fractures
Children are prone to injuries and fractures due to their active lifestyle. Some of the most common paediatric fractures are:
- Finger, hand, or wrist fractures
- Ankle or foot fractures from sports and physical activities
- Arms and elbows, or shoulder dislocation
- Shins, thighs, or leg fractures
Signs and symptoms of Paediatric Fractures
- pain or swelling in the injured limb
- obvious deformity
- difficulty using or moving the affected area
- warmth, bruising or redness
Immediate medical attention is required if symptoms are present. For compound fractures (bone visible through broken skin), keep the child still and call an ambulance.
Common Causes of Paediatric Fractures
- Injuries from activities, like dance and karate
- Track and field injuries from athletics and gymnastics
- Sports injuries from footy, cricket, tennis
- Injuries from surfing, skating, bike riding
- Falls from trampolines, horseback riding or rock-climbing
- Weak bones due to calcium deficiency
- Obesity due to over-eating and in-activity
Types of Non-displaced Paediatric Fractures
- Single non-displaced fracture is when the bone breaks but stays aligned in an acceptable position for healing. Non-displaced fractures are usually managed with a removable cast, splint, or brace to immobilize the injured bone, reduce pain and swelling, and promote healing.
- Stress or Hairline fracture is when tiny cracks form due to overuse or repetitive stress-bearing motions. Stress fractures are common in children who run track or participate in gymnastics or dance.
- Torus/buckle fracture is when the bone is dented but not broken as it bends upon itself like a buckle. This is a common childhood injury that typically results from a simple fall.
Types of Displaced Paediatric Fractures
- Angulated fracture with broken ends at an angle
- Translated fracture with ends shifted out of alignment
- Rotated fracture with bone spun during break
- Greenstick fracture with one side broken and some parts of the bone still attached or bent
In case a fracture is displaced and the ends of the bone out of alignment, the broken bone needs to be set back into alignment so it heals properly. This is called a reduction. After the reduction, the injured limb is immobilized with a brace, splint, or cast while the bone heals. Other treatment may be necessary if the reduction is unsuccessful. Luckily, children’s fractures have a great potential to “remodel” after healing and often correct themselves over time as the child grows.
Paediatric Fracture Diagnosis
A Fracture Clinic specialist will closely examine the injured area for tenderness, redness, and swelling and will order diagnostic imaging tests to determine what type of treatment is appropriate. Diagnostic testing for fractures may include:
- X-Ray
- Computed Tomography scan (CT, CAT scan) shows great detail not visible on x-rays.
- Magnetic Resonance Imaging (MRI) is needed to detect fractures (such as stress fractures) that don’t show up on an X-ray until after the bone starts hurting. An MRI can pick up smaller fractures before they get worse.
- Bone Scan
Paediatric Fracture Treatment
Treatment is based on the type of fracture, its severity, and your child’s age. Here are the treatment options:
- Splints/split casts: used initially for swelling
- Boots and casts to stabilise the fracture
- Reduction: non-surgical realignment that is usually performed in ER or OT with medication to manage pain and make your child sleepy or sedated so they won’t remember the procedure.
- Surgery for severe or unstable fractures that are unlikely to “remodel” themselves or can’t be set properly with a gentle reduction.
We refer children requiring surgery to an Orthopaedic Surgeon of your choice or to the public system if that is preferred. To ensure that the bone will heal in the correct position, your child’s doctor will decide very early in treatment whether surgery is likely to be required.
Follow-up Care for Paediatric Fractures
After applying a removable cast, regular monitoring and child-parent education become crucial. This helps your child heal well and avoid complications for the next six weeks. In the first two weeks, parents of children with casts should look for:
- Signs of skin irritation, break-out, foul odour or drainage from the cast
- Unusual swelling, discoloration, increase in pain or discomfort.
- Fingers or toes becoming pale, blue (due to blood circulation issues)
- Any damage to the cast – loose, dirty, wet or broken.
During the follow-up appointment, we :
- Assess your child’s pain levels
- Evaluate their fracture healing process
- Check the integrity of the cast or splint
- Ensure proper alignment and positioning (with an X-Ray)
- Discuss any concerns or questions with the patient and parents
- Commence rehabilitation exercises, if appropriate.
Severe fractures
- Comminuted: multiple pieces
- Compression: bone collapse under pressure
- Growth plate fractures
- Open (compound) fractures: bone penetrates skin
Bone fractures are classified as either open or closed. A closed fracture occurs when the bone is broken, but the skin remains intact. An open fracture, also known as a compound fracture, occurs when the broken bone breaks through the skin. Open fractures are not common and require surgery in hospital as they can become infected if not treated appropriately with a surgical washout.
Growth plate fractures
Growth plate fractures are typically caused by great force during sports or playground accidents. Depending on the seriousness of the fracture, they may be treated with orthoses like splint, cast, or walking boot. Some serious growth plate fractures require surgery.
In some cases, growth plate fractures can slow down the affected limb’s growth. A damaged growth plate can also cause the limb to grow at a wrong angle. Surgeons operate must protect the child’s growth plates as much as possible during a paediatric fracture surgery.
How can I book an appointment at the Fracture Clinic?
You can call their phone number or make an appointment online via their website. The clinic is open from 8 a.m. to 4 p.m., Monday through Friday.
Do you accept insurance?
We work with multiple health insurance providers. We offer Medicare rebates where applicable and can assist you in understanding your potential coverage. We recommend:
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Checking your specific insurance policy for physiotherapy, or orthopaedic specialist coverage
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Bringing your Medicare card and private health insurance details to your consultation
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Consulting with our team for precise rebate information, especially if you have DVA or WorkCover coverage
We are committed to transparent pricing and we will provide a comprehensive breakdown of potential costs and rebates during your initial consultation. For patients with eligible Medicare, DVA, WorkCover and/or private health insurance, out-of-pocket expenses can be significantly reduced.
