Signs of a Pediatric Fracture

At every age, kids take sports and play seriously and do not want to be sidelined by an injury. The winter weather season creates new challenges. Winter sports and activities often bring new injuries that can cause significant issues for our patients and their families.

Common winter sports such as basketball, skiing, snowboarding, figure skating and hockey, in addition to recreational activities like ice fishing, sledding, skating and snowmobiling can cause a wide array of injuries in children. Regardless of the severity of injury, the specialists at Shriners Children’s are here to help.

One study found that the most common sledding injuries seen in emergency rooms are broken bones (26%), contusions and abrasions (25%), lacerations or deep cuts (16%), sprains (16%) and traumatic brain injury (9%). The most common areas of injury are the head, arms and legs.

Is My Bone Broken?

“Sometimes it can be difficult to determine if there is a broken bone,” said Shriners Children’s Spokane pediatrician Ryan Baker, M.D. “If there is a deformity it’s easy, but sometimes it can mimic a wrist sprain.”

The most common injuries in the winter range from mild sprains to significant fractures that require surgery. It is important to remember that pediatric orthopedic specialists are best equipped to evaluate, diagnose and treat pediatric injuries, as there are special considerations to take when evaluating and treating pediatric patients.

Children are not small adults and the developing skeletal system responds differently than the adult skeletal system to trauma. The same mechanism of injury that may cause a sprain or strain in an adult, or even a teenager who is skeletally mature, may cause a growth plate injury in a child who has not reached skeletal maturity. This is because of actively growing bone at the epiphysis, metaphysis and apophysis, collectively referred to as the “growth plates.” This area of developing bone creates an area of instability that can be more easily injured, and providers who do not commonly treat children may not be able to recognize these injuries or treat them appropriately.

“If a child is tender over the bone or there is a lot of swelling fairly quickly, I would start to think there could be a fracture,” added Dr. Baker. “As long as there isn’t a deformity, waiting to see how things play out is a possibility, but if pain persists, then getting an X-ray to confirm would be recommended.”

X-rays expose children to radiation in low doses, but at Shriners Children's, we take additional steps to reduce this exposure. Many locations use EOS imaging. EOS is a medical imaging system that provides 360-degree images while limiting the X-ray dose absorbed by the patient who is either sitting or standing.