As parents, we often wish we could wrap our children up in cotton wool and stop them running around and hurting themselves. Unfortunately we can’t, and as a result children often break bones. As children’s bones are still growing, the type of fractures they sustain and the way they heal and are managed is very different from adults. A child’s bone is not as dense as an adult and has lots of capillary channels as well as a lower mineral content. Most importantly the long bones in children have growth plates (physes). This is the area where new bone tissues are produced and this will determine the final length and shape of the bone.
Types of Fractures:
The types of fracture your child could sustain can be classified into the following main types:
Buckle or torus fracture
This is where one side of the bone bends or buckles from a force without breaking the other side.
One side of the bone is broken and this causes the other side to bend.
The fracture goes through the bone and can be classified depending on the fracture line:
Spiral fractures are caused by a rotational/twisting force.
Oblique fractures are where the fracture line runs diagonally across the bone.
Transverse fractures are where the bone is broken straight across from the result of a direct blow.
This is a fracture to the growth plate and may result in deformity, limb-length inconsistency or joint problems. Based on the radiographic appearance of the fracture, they are classified by the Salter-Harris classification system.
Fortunately, children heal more quickly than adults, due to a more active membrane, which covers the outer surface of bones, called the periosteum. However, very quick healing can sometimes result in re-fracturing. Due to children’s ability to heal quickly, management of paediatric fractures is generally quite straightforward and will just require a cast to be applied for a few weeks. However, if it is bad fracture a child may require plates and screws to be put in to align the bone. If the growth plate is damaged, the management can be difficult and can be complicated by progressive deformities with growth as the child gets older. In this instance, a child may require invasive surgery such as leg lengthening.
The rehabilitation following a fracture can vary greatly. Some children will back to normal once the cast is removed, whilst others will find they have lost range within a joint and have severe muscle wasting. These children require intense physio to restore movement in the joint and get them back to full strength. If it is a lower limb fracture, your child may require help learning to walk again with a normal pattern as well as help with getting back to sports. If your child has sustained a fracture, then our fantastic team of physios can get your child back to their normal activities. Contact us today to arrange an initial assessment for your child.