Frequently Asked Questions

• What causes a fracture?

  A fracture is a partial or complete break in a bone. It occurs when more force is applied to a bone than it can absorb. Your child could suffer a bone break from a fall or trauma, or as a result of a direct blow to the body.

  A bone break can be an open fracture (also called a compound fracture), where the bone is visible through the skin, or it can be a closed (or simple) fracture where the skin remains intact.

• Are there differences in fractures in children compared with fractures in an adult?

  No. The same forces that cause bone breaks in adults cause bone breaks in children. However, children’s bones are softer than those of adults and tend to buckle or bend rather than completely break. Also, a child’s bone heals much faster than an adult’s bone. The younger the child, the faster the healing occurs.

  But the long-term impact of fractures can be more complex for children, as they have open growth plates (epiphysis) at the end of their long bones. This is an area where the bone grows. Injury to the growth plate can lead to limb-length discrepancies or angular deformities.

• Are there different types of fractures?

  Common types of fractures that occur in children include.

  • Greenstick – an incomplete fracture, where a portion of the bone is broken, causing the other side to bend
  • Transverse – when the break is in a straight line across the bone
  • Spiral – when the break spirals around the bone (common in a twisting injury)
  • Oblique – a diagonal break across the bone
  • Compression – when the bone is crushed, causing the broken bone to be wider or flatter in appearance
  • Comminuted – when the break is in three or more pieces

  If your child suffers a fracture, a physician will apply a cast to help the broken bone heal.

• What does a cast do?

  Casts immobilize the joint above and the joint below the area that is to be kept straight and without motion. For example, a child with a forearm fracture will have a long arm cast to immobilize the wrist and elbow joints.

  Cast types fall in two primary types: upper extremity and lower extremity. Upper extremity casts include the short arm and long arm casts and the arm cylinder cast. Lower extremity casts include the short leg cast, the long leg cast and the leg cylinder cast.

• How can my child move around while in a cast?

  A cast is designed to restrict mobility but, depending on the nature of the fracture, your child can move around in a cast, thanks to assistive devices such as crutches, walkers, wagons and wheelchairs.

• How can I help my child while he or she is in a cast?

  As a parent, you’ll need to oversee the care of the cast to avoid re-injury, discomfort or infection. This means keeping the cast clean and dry, checking for cracks or breaks in the cast, refraining from putting powders or lotions inside the cast, covering the cast while your child is eating (to prevent spills and crumbs from entering the cast), encouraging your child to move his or her fingers or toes to promote circulation and discouraging your child from inserting objects under the cast to scratch the skin. If itchiness becomes a problem, you can use a hairdryer placed on a cool setting to blow air under the cast and cool down the hot, itchy skin. If your child is in a body cast, you may need to provide him or her with a bedpan or portable urinal.

  Follow these tips for preventing infection or discomfort for a child in a body cast:

  • Keep the genital area as clean and dry as possible to prevent skin irritation.
  • Use a diaper or sanitary napkin around the genital area to prevent leakage or splashing of urine.
  • Place toilet paper inside the bedpan to prevent urine from splashing onto the cast or bed.