Aaahhh, summertime in Texas. As the weather heats up and the rain showers decrease, it is time for the outdoor activities to begin. With this warmer weather and newfound freedom come some un-welcomed consequences. Especially this summer, when we are all reaching “pandemic fatigue” and “Zoom fatigue.” I can hear the gentle yells of my wife to our kids, “GET OUTSIDE! ENOUGH SCREEN TIME! JUST GO!” (Disclaimer – in order to preserve my happy marriage, there is some exaggeration…although not really).
Most Common Activities that Cause Fractures
As an orthopedic surgeon, there are three things that my kids will not experience at our house:
All of these are fun and don’t think for a second my kids aren’t at the neighbor’s house jumping on their trampoline while playing football. But this does bring up the question of what activities tend to lead toward a broken bone?
In my experience, the most common activities that cause fractures are (in no particular order): trampolines, monkey bars, playground equipment (especially in younger kids), contact sports, scooters and skateboards, hoverboards, and siblings.
In one memorable patient story a boy encouraged his twin brother to walk on the outside rim of the trampoline and then gently shoved him off the edge. Sounds like something my brothers would do to me.
How to Prevent Fractures
So…is it reasonable to bubble wrap your child, keep them safely distanced from their brother/sister and never allow them to have fun? At our house, we tried it for a day, however unsuccessfully. What is a parent to do?
Focus on the things you can control. If Chance is going to ride his bike or RipStik, then he needs to wear good shoes and his helmet. If we are worried about wrist injuries, then a wrist guard for skateboarders makes sense. For our younger patients, extra supervision on the playground is helpful.
These are developing years and striking the right balance of autonomy and supervision can be hard. We want our kids to learn and experience new things. So find a way to be around them, but yet still allow them some autonomy and play.
With regards to trampolines, the American Academy of Pediatrics suggests: “trampolines should never be used unless athletes are being supervised in training for a sport.” Smaller children are more likely to be injured on trampolines than older children. And multiple kids jumping at the same time tends to cause the majority of injuries.
In order to keep your child safe, we recommend the following rules for trampoline play:
Have the springs covered
Use a safety net around the trampoline
One person at a time
Avoid somersaults and flips (these can lead to cervical spine injuries)
Supervise the activity
By now you understand that I am not much fun at parties. I’m that parent walking around at the commercial trampoline park (yes my kids still go to these) hovering around my kids. I told my wife that these outings are not good for my blood pressure.
So what do you do when you think your child has a fracture?
First thing is to make sure that your child did not hit their head or sustain another more serious problem. Next, look at the extremity. Obviously if the arm or leg is deformed, you need to go to an Emergency Department or locally trusted urgent care to get x-rays and have a discussion regarding treatment.
I tell friends and families the following: if you think it will require surgery then go to your local Pediatric Emergency Department. They will have the right specialists on-call to help care for your child.
If you look at the extremity and it is swollen and bruised, then I recommend getting an x-ray within the first 48 hours. Pain and discomfort will drive you to seek care sooner. Depending on the body part and severity, treatment will differ from a splint or brace to casting or even surgery.
No matter where you get the x-rays it is helpful to request a CD or web link to take with you. This will avoid the need to repeat x-rays. That being said, there are times when new or different x-ray views will be needed. Your pediatric orthopedic surgeon should review the films with you and then help make that decision.
These are general guidelines and obviously care will differ for each fracture and child. We know fractures can be scary, but CTPO is here to help guide you and your child on the road to recovery.
About Dr. Gottschalk
Dr. Hilton Gottschalk is a Board-Certified Pediatric Orthopedic Surgeon and is President and CEO of Central Texas Pediatric Orthopedics. He resides in Austin with his wife and two children and is a Dell Medical School Compassion and Character Award recipient. Dr. Gottschalk’s subspecialty focus includes treatment of hand and upper extremity disorders, including fractures, sports injuries and congenital disorders.