Fractures are a common occurrence in childhood, with a significant percentage of children experiencing a broken bone during their growing years. Up to 50% of children may experience a fracture. While accidents can happen at any age, the bones of children respond to forces differently than adult bones due to their unique composition and ongoing development.
Unique Characteristics of Children’s Bones
Children’s bones possess distinct features that make them prone to specific fracture patterns. A primary difference is the presence of growth plates, also known as physes, located near the ends of long bones. These cartilaginous areas are responsible for longitudinal bone growth and are typically weaker than the surrounding ligaments and joint capsules. This structural characteristic means that an injury that might cause a ligamentous tear or joint dislocation in an adult could result in a growth plate fracture in a child.
Children’s bones are also more flexible and elastic compared to adult bones, due to a higher cartilage content and a different bone structure that is more porous. This allows a child’s bone to bend considerably before a complete break occurs. The periosteum, a tough membrane covering the bone, is thicker and stronger in children. This robust periosteum can act like a hinge, containing certain fractures and inhibiting severe displacement, contributing to the occurrence of incomplete fracture types.
Common Fracture Types in Children
A common injury is a greenstick fracture, where the bone bends and breaks on only one side, while the other side remains intact. This is similar to how a young, flexible tree branch might splinter when bent. Greenstick fractures often occur in the forearm and reflect the bone’s inherent flexibility.
A torus, or buckle, fracture, is an incomplete fracture where the bone buckles or bulges outwards, often due to a compression force. These fractures frequently happen around the wrist when a child falls onto an outstretched hand and are considered stable injuries.
Growth plate, or physeal, fractures involve the cartilaginous growth plates that are crucial for bone lengthening. Damage to the growth plate can potentially affect future bone growth, leading to limb length discrepancies or angular deformities.
Supracondylar fractures are seen around the elbow, in the humerus just above the elbow joint. These fractures often result from falling onto an outstretched arm and can be a concern due to the potential for nerve or blood vessel involvement. Spiral fractures occur when a twisting force is applied along the bone’s axis, causing the fracture line to spiral around the bone. These can affect various long bones.
Recognizing and Treating Children’s Fractures
Recognizing a potential fracture in a child involves observing common signs and symptoms. These may include localized pain, swelling, bruising, and noticeable deformity of the limb. The child might also have difficulty moving the injured limb or bearing weight on it.
Diagnosis involves a physical examination and imaging studies, with X-rays being the primary tool to visualize the bone and determine the type and location of the fracture. Treatment approaches for children’s fractures focus on immobilizing the injured area to allow the bone to heal. This involves the use of casts, splints, or braces. If the bone fragments are displaced, a procedure called reduction may be performed to realign the bone. Children’s bones heal faster than adult bones due to their active growth and robust blood supply.
Preventing Childhood Fractures
Preventing childhood fractures involves creating safe environments and promoting safe practices. This includes supervising children on playgrounds and verifying that equipment is age-appropriate and well-maintained with soft surfaces. Using appropriate safety gear during sports and recreational activities, like helmets for biking and protective pads for other sports, helps prevent injuries.
Childproofing the home is also a measure to reduce fracture risks. This includes installing stair gates, securing furniture to prevent tipping, and using window guards. Encouraging children to engage in regular physical activity, including weight-bearing exercises like running and jumping, contributes to stronger bones.