There are 206 bones in the human body and all of
them can break. Some are more vulnerable than others, but when a
child gets injured and complains of pain in a finger, toe, arm or
leg, the possibility of a broken bone creates a huge dilemma for
parents. Most want to know: (1) how can I tell if it's broken and
(2) should we go to the emergency department? The answer to the
first question is that it isn't always obvious-even to a
doctor-which is why the answer to the second question is almost
A broken bone is also called a fracture. Fractures can
cause swelling, tenderness and pain, but small breaks can be subtle
and sometimes a child will not complain much. If you think your
child has a fracture, it's reasonable to go to an emergency
department to get it checked out. On the other hand, if your child
is calm and comfortable you can take some deep breaths and call
your pediatrician for guidance.
The best way to be sure about whether a bone is broken is
to get an X-ray. It's painless and effective, but even an X-ray can
miss a very small fracture. If the doctor has a high suspicion of a
fracture, even if it isn't visible on the X-ray, a cast will
usually be applied and the bone will be X-rayed again in a few days
to check for signs of healing.
In most cases, a fracture isn't going to cause immediate
harm, but sometimes it creates an obvious deformity and, in more
severe cases, a part of the bone can even break through the skin.
These are true emergencies and the child should be sent by
ambulance to the nearest emergency department. Fortunately, that's
The treatment of fractures can vary widely, depending on
the severity and location of the break. In general, the goal of
treating a fracture is to make sure the bones are "aligned" (which
means they are in the same general position they were in before the
fracture) and held still (immobilized) so they can heal
Limiting bone movement will also help reduce the pain, but
oral pain medications should be used as needed.
In some cases, a simple splint can be used to immobilize a
fracture. In other cases, a cast is needed. Sometimes a very big
cast is needed for a very small fracture because the bones above
and below the break must also be held still. Rarely, a child will
need an operation to correct the break.
It's important to mention that none of these methods has
healing properties; they just hold the bones very still while the
body naturally mends the injury. The early stages of bone healing
happen in four to six weeks and at that point the cast is removed.
Even though early bone healing happens fast, the fracture isn't
completely healed for more than a year.
The vast majority of broken bones heal well and without
complications, but in rare cases fractures can cause long-term
problems. Some breaks can cause damage to the growth center of the
bone, which leads to "growth arrest" and an obvious difference in
the length of one leg compared to the other. Sometimes bones don't
mend correctly or at all and need an operation to help the process
Dr. Lisa Thornton, a mother of three, is director of
pediatric rehabilitation at Schwab Rehabilitation Hospital and
LaRabida Children's Hospital. She also is assistant professor of
pediatrics at the University of Chicago. E-mail her at
Dr. Lisa Thornton, a mother of three, is director of pediatric rehabilitation at Schwab Rehabilitation Hospital and LaRabida Children’s Hospital. She also is assistant professor of pediatrics at the University of Chicago.
See more of Dr. Thornton's stories here.
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