Take these precautions to prevent Bone Injuries in children

Children sustain bone injuries due to various causes. Common causes are sports related injuries and falls from cycles. Apart from this, we see children presenting with injuries due to fall from heights and motor vehicle accidents. Commonly they sustain injuries to their forearms, wrists, elbows and legs.

Children’s fractures are different from adult fractures. Bones are more flexible, resulting in greenstick fractures and bowing rather than complete fractures. Also, lining of the bones is very thick, not allowing fractures to displace more. These lining helps to heal and remodel much faster than in adults. Bones grow at both ends. Any damage to growth plate needs proper care -  it could otherwise result in deformities and growth arrest. 

Nature of fracture varies from simple buckle fracture to completely displaced, comminuted open fractures based on nature of injury. Fall from heights and road traffic accidents result in severe injuries. 

Its important to remember most of these injuries are preventable. Adequate protective wear while playing like guards around knee and elbow while skating, not allowing children unattended while playing on the roads, having high enough barrier in the high rise building to prevent children falling are few examples.

Since children may not be able to tell the nature of injuries, it is strongly advised to take medical help at the earliest for any suspected fractures. They may be in pain and difficult to move the ilmbs or there may be an obvious deformity of the limb.  In case of any deformity or severe pain, we splint the limb and give pain medications till further treatment is given. Most fractures need simple casting after making sure bones are in good alignment. Since, children are in pain and scared, any manipulation and casting is done under anaesthesia. 

Surgery is planned for any open fractures or any badly displaced fractures. Children’s orthopedic surgeon manage fractures to ensure normal bone growth. Implants used in children’s fractures are different from adults to prevent damage to the growth plate. 

Child will be in plaster for some time for the fracture to heal in good alignment. During this period, proper care of the plaster cast is very important to prevent plaster related complications. If properly managed, fractures heal well without any growth related complications and can go back to normal activities within two months.

Featuring insights from Dr. R.Sankar, Pediatric Orthopedic Surgeon, Apollo Children's Hospitals, Chennai. 

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