Children's bones are softer and more porous than adult bones and therefore may be treated differently. Treatment often depends on the type of fracture, and whether the fracture is in a still growing bone (growth plate fracture). Pediatric fractures occur more commonly in boys, often related to sports, with the most common being forearm fractures, hand fractures, and carpal-metacarpal (wrist) fractures. If a fracture involves bone breaking through the skin, it is called a compound fracture or an open fracture. In general, fractures in children heal more quickly than in adults.
Some examples of fracture types include:
- Buckle fracture or compression fracture – when a bone is “buckled” to one side but doesn't break
- Greenstick fracture – when the bone bends but doesn't break all the way through, similar to how a small green branch from a tree might bend without breaking
- Growth plate fracture – when there is a break in a growing bone
- Stress fracture – when there is a crack in a bone
A pediatric fracture is treated with a cast, splint or brace to stabilize the bone, which may need to be “set” or realigned before being stabilized. This is called reduction.
The process of reduction is done in two ways:
- Closed reduction – when medication is given to relieve pain and the bone is realigned; no incision (cut) involved
- Open reduction – when the injury is more complex, surgery may be performed to align bones and stabilize with screws, plates and wires; incision is needed, under anesthesia (child is sleeping)
Bone remodeling in children
Because children's bones are more flexible and adaptable, the bones “remodel” with growth. This means the bones heals themselves and grow in the direction they're normally supposed to grow without having to be perfectly set or aligned. How much bone setting is needed depends again on the type of fracture. More complex injuries generally require more precise bone alignment.
Pediatric fracture recovery time
At first a blood clot will form around the fractured area followed by healing tissue that forms over the next few weeks. It will take several months for the bone to heal completely, sometimes longer depending on the severity of the fracture. Your doctor will advise your child on what kinds of activities are okay to participate in and when it's appropriate to return to sports and more active physical activity. In general, children recover well from pediatric fractures and their bones heal successfully.