Dealing with Child Fractures, Signs of a Broken Bone, Nature of fracture - Health Education - DesiMD Healthcare - India
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Dealing with Child Fractures

Dr.Surya Rao Poodipeddi profile Authored by Dr.Surya Rao Poodipeddi on 11 Jul 2014 - 17:24.

child fracture

Like adults infants and children are also susceptible to fractures and dislocations, but differ from the adults. Bones in babies are so pliable that they rarely break. Depending on the impact of a fall or a hit, the bones in infants and children generally bend. This type of fracture causing a bend is termed as a greenstick fracture.

In some cases infants may sustain sprains without the bone being either bent or broken. It is very difficult to identify whether there is a fracture or the child has just fallen and is crying. If the baby’s injury only swells a little bit and he doesn’t seem to be much in pain it is alright for the mother to treat it with ice and wait a day or two. If the swelling goes down and things improve we can presume it is only a sprain. But, if the swelling has gradually increased and the child is in discomfort, and crying on slight touch over the swollen area, with lack of movements over the joint, it is time to call a doctor and seek his advice. However to be safe and cautious, it is always preferred to see the doctor, if in doubt.

Signs of a broken bone:

  • A snapping sound (usually called crepitus.) One should however never try to elicit this sound.
  • Bruising
  • Painful on touch (tenderness)
  • Severe pain particularly over one spot.
  • Stiffness
  • The child refuses to move the joint and refuses to be touched in that spot.
  • An appearance of being bent or out of position.

It is important to note that simply because the child is able to walk or move his limbs or digits there is no fracture. This is a myth. One should exclude this to rule out the possibility of a fracture.

Nature of fracture, caution and medical attention:

In some kids the impact of the injury due to an accident may be severe enough to cause protrusion of a bone which pierces through the skin to the outside. This type of break is called an open fracture. Because of internal bleeding and likely damage to the internal tissues, this type of fracture is considered very dangerous. Such situations warrant immediate shift of the child to the emergency keeping the child as comfortable as possible. Wrap the site with a sterile gauge without disturbing the protruding bone and call for emergency.

If there is a suspicion of the child sustaining a fracture, the injured area must be protected and immobilized making sure that the baby doesn’t worsen the already existing damage. Most importantly comfort the baby and take the child to the nearest emergency center. It is better to avoid giving the child anything by mouth including the feed, because the child might need reduction of a fracture under anesthesia if the x-ray reveals fracture(s). Never attempt to straighten or change the position of a dislocated limb or bone, because you will be doing more harm than good and may even worsen the problem.

The child must be watched for symptoms of shock as a result of fracture with internal injury. The warning signs and symptoms of an impending shock are:

  • A weak, rapid or irregular pulse.
  • Cold or bluish skin
  • Breathing becomes shallow and rapid
  • Confusion or even loss of consciousness
  • Coughing up of blood or in some cases vomiting of blood.

Once you are convinced that the child has a fracture or dislocation, caution must be exercised in handling the child with care while shifting to the hospital.

Unless you suspect a serious injury to the head, neck or spine it is okay if you shift the child. If the child has a bad break or dislocation, it is essential to immobilize the broken bone or dislocated joint with improvised splints to minimize any further injury during transit.

Remembering the following formula helps to keep the child in comfort before shifting to a medical center: ICES - Ice, Compression, Elevation, Support.

Ice decreases pain and swelling and if not readily available, anything from the freezer compartment can be wrapped in a bag and used as an ice pack. Compression decreases swelling. After using an ice pack, the injure area must be wrapped in a bandage, not too loose or too tight . Elevation helps decrease pain and swelling and gives comfort. If the baby can be made to lie down, a pillow can be placed under the affected limb so that it is elevated about 6 inches above the heart level. Support helps to immobilize the limb and reduces pain. By placing a splint over the affected part, anything which can work like a splint helps to support the injured area. If a fracture over a rib, arm or collarbone is suspected, using a triangular bandage or a cloth cut into a triangular shape can be used as a sling to give comfort to the child.

Some infants are prone to sustain dislocation of elbow or a shoulder due to faulty handling of a child. Sometimes the maid lifts the child up holding the child at the hands and the sudden pull may dislocate a shoulder or elbow. It is therefore important for mothers to instruct the maids never to lift the child like this.

The thumb rule in all cases of a suspected fracture or dislocation is never to handle the injury yourself, but to seek medical help even if there is a slightest suspicion. Put a splint on the affected limb. If you suspect a broken arm, rib, or collarbone, use a cloth or diaper sling to hold the arm in a bent position next to your baby's body.     

*Disclaimer
*Disclaimer: This is not medical advice. The content is for educational purposes only. Please contact your doctor for any health care issues.