Awareness December 17, 2021
Is my child’s arm broken?
Your child has fallen while playing and is now crying in pain. The first thing you might think is, “Is it broken?” But it’s not always easy to tell, especially if the child is too young to describe what they’re feeling. “Usually, you’ll notice swelling, and your child will clearly be in pain and unable – or unwilling – to move the injured limb,” says Vinny Pillay, an emergency care practitioner at ER24 Pietermaritzburg. “But remember, even if your child can move the bone, it doesn’t necessarily rule out a fracture.”
If the break is severe, or you think your child might have injured their neck or spine, call 084 124 for real help, real fast. Don’t move the child or try to push the bone back under the skin. Otherwise, until you can get medical help, make your child as comfortable as possible:
- Cut away or gently remove clothing from the injured area if possible.
- Apply a cold pack to the affected area to reduce swelling. Avoid applying ice directly to the body as it may cause cell damage.
- Stabilise the injured area with a splint, or support it with a cushion or pillow – a magazine or rolled-up newspaper secured with tape can act as a temporary splint. A sling made from a towel or piece of clothing can also help keep an injured arm in place.
- Don’t give the child anything to drink or eat, just in case they need surgery.
When adults break bones, they often need surgery. However, as children’s bones are more flexible and better able to absorb shock, healing often just requires a cast and/or resting the affected bone. “The reason is fairly simple – children have a higher potential for bone regrowth,” says Dr Richard Finn, an orthopaedic surgeon at Mediclinic Worcester.
Rather than a broken bone (which you’d more likely find in an adult), children tend to have “greenstick” fractures, Dr Finn adds. “This is where the outside of the bone is fractured, and the other side is intact. It’s like when you take a green stick and bend it; you’ll see the bark on one side will crack, and the bark on the other side will stay intact. In children, the membrane that covers the bones is thicker. The outside of their bones is a lot thicker and more pliable, whereas, in adults, it’s a rigid structure.”
Two other types of fracture
- Torus: the bone is twisted and weakened but not completely broken.
- Complete: the bone breaks all the way through.
Pillay adds that your child’s bones are still growing, so the right treatment can have a long-term impact on how the bone heals.
Boys will be boys
One study of 526 children showed that 73% of paediatric admissions to a South African provincial hospital between 1 January 2016 and 31 December 2017 were boys, and the average age was seven years. A fall on ground level was the most common cause of injury (70%), followed by pedestrian-vehicle accidents (12.2%). The most frequently fractured regions were the forearm (36.4%), humerus (26.5%) and femur (18.9%), with multiple fractures in 2.4% of the subjects and additional non-skeletal injuries in 2.9%.