Does my Child have a Fracture?
By: Hilton Gottschalk, MD, FAAOS
"Every parent knows what that scream sounds like that perks your ears up and you think ...
that's not right. There's a reason I don't need to own a trampoline. I don't need more business
for myself! But my neighbors love trampolines, my kids love trampolines, my kids will then go
to the neighbor's house and jump on the trampoline.
When kids injure themselves the biggest question is always what do you do next and how do you know when it's injured? Most of the time what I tell families or my neighbors is to look at the extremity. If there's bruising, if there's an obvious deformity, if there's swelling, something's up. The best thing to do typically is to go get an x-ray so that you can make sure.
How to Make Your Child Comfortable
A lot of times these injuries happen on the weekend and you're trying to decide do you go to the urgent care, do you go to the ER, do you wait 'till Monday. What do you do to keep your kid comfortable because it's not bad enough that you have to rush them in but clearly something's not right.
Some basic things to do:
Number one is rest. Don't have them go jumping and playing on the playground, stop them from swimming etc.
If ice feels good for your child (it's going to help bring some of that swelling down) then do it. Ice is good for 20-minute intervals and after that you need to take a break for an hour and then reapply it for 20 minutes. Don't put the ice directly on the skin, put a towel between there as a buffer otherwise it's not going to feel really good. Younger kids don't like extreme temperatures like ice or heat and they will tell you that so don't force it.
How Can I Treat At Home?
I'm okay with giving a pain medication such as an over-the-counter medicine if your child can take Ibuprofen or Tylenol to help them be comfortable at night so they don't have to be miserable.
Depending on the body part there are some pre-made splints and wrist guards that you can go to the store and go get. Different pharmacies have these, absolutely and by all means go get one that you think is going to fit well for your child and to allow them to have at least a comfortable night's rest or during the daytime.
Elevating it is typically good -- grab those pillows, grab those lovies and I tell parents once you've stabilized the wrist or the forearm put those pillows so that the hand is above the elbow about 45 degrees so that ultimately it can help bring some of that swelling down and keep them comfortable.
What to do if At-Home Treatments Don't Work
If you can wait a day and it's not deformed you can give them either Ibuprofen or Tylenol (or whatever your child can take) to help with the pain. Elevate it and stop the activity. If it's still swollen or bruised and they don't want to move it that next morning let's get the x-ray.
A lot of times families will go to other places and they'll get certain x-rays and then we need to either look at those x-rays or repeat new ones because it wasn't the right x-ray that we needed to really evaluate the entire bone or to specifically look at a specific joint area. We need to be able to review those x-rays in their entirety and understand what's going on.
I think as parents we don't always know what to do. It's overwhelming and it's your child and you're focused on making sure that your child is not in pain and you don't know what to do or where to go. Give us a call, we're here for you. A lot of times a simple phone call can help guide you and a couple of simple questions can help us to guide you the best way possible."
About Dr. Hilton Gottschalk
Dr. Gottschalk is a Board-Certified Pediatric Orthopedic Surgeon and is President and CEO of Central Texas Pediatric Orthopedics.
Dr. Gottschalk attended Texas A&M University, followed by the University of Texas Health Science Center at San Antonio.
He completed residency in Orthopedic Surgery at UT Southwestern Medical Center, along with Senior Registrar Orthopedics at Norfolk & Norwich University. He also completed a Pediatric Orthopedic and Scoliosis Fellowship at Rady Children’s Hospital, along with a Hand Fellowship (Pediatric and Adult) at Loyola University. He resides in Austin with his wife and two children and is a Dell Medical School Compassion and Character Award recipient.
Click here to learn more about Dr. Gottschalk.