My Child Has a Broken Bone
If your child has been diagnosed with a fracture, it is important to call to make an appointment approximately 5-7 days after the injury. If your child has not been seen by a health care professional, but you are concerned about a fracture, please make an appointment as well. You can contact us by scheduling an appointment online. Same day appointments are almost always available if you contact us in the morning. If you have a CD of the x-rays, then please bring it with you as this will be very helpful.
If you suspect that your child has a fractured or broken bone or if your child has been diagnosed with a fracture or a broken bone, please consider the following:
If you haven't seen a doctor yet, you need to determine the urgency of the situation:
You should consider taking your child to the emergency room if any of the following are true:
- The skin is not intact (i.e. - the bone has pierced through the skin)
- Your child feels numbness or tingling in the broken/injured area
- You cannot control your child's pain
If none of the above are true, then it is likely not a true medical emergency. However, it is important to seek early treatment for all fractures in children. Bone in kids will begin to heal quickly, even if it is in the wrong place. But not all fracture care needs to be seen immediately in the Emergency Department.
To determine the appropriate place to seek care, consider what time of the day and day of the week it is.
If it is during business hours on days Monday through Friday, please call our office at 404-255-1933. We provide same day trauma appointments at one of our nine office locations, when medically necessary. The office is the ideal place to be seen for all of your childs' trauma needs including: pediatric orthopaedic care, X-rays, splinting and casting. If it is determined that your child will need his/her bone "set" under sedation, we can also schedule that at your convenience.
If it is already after hours or during the weekend, and you feel that your child needs medical attention immediately, the Children's Healthcare of Atlanta's Immediate Care Centers would be a great option. Our physicians handle the majority of the orthopaedic oversight at these facilities. The Immediate Care Center's provide pediatric orthopaedic oversight, X-ray and splinting. Should a reduction be necessary and you choose COA to manage your orthopaedic care, our nurse can schedule the procedure (with sedation) within the next few days. This means you can go home and get some rest instead of being sent immediately to the Emergency Department for the reduction, possibly without sedation. Casting will also be performed at this time. If the Children's Healthcare of Atlanta's Immediate Care Centers are closed (after 9 p.m.), the best place to be seen is in one of the Children's Emergency Departments at Egleston or Scottish Rite. Our physicians handle 100% of the orthopaedics call for Scottish Rite and a portion of the call for Egleston. At the Children's Emergency Departments you will find pediatric orthopaedic oversight, X-ray, splinting, casting and reductions (with possible sedation).
If it is already after hours or during the weekend, and you feel that your child does not need medical attention immediately, you can call our fracture care hotline at 678-686-6800 and leave a message. You will receive a response either that evening or early the following day. We will be able to accommodate your child for a same-day appointment, often at your preferred location. Another option would be to schedule an appointment. Again, you can expect prompt service from our scheduling team.
If you have already seen a doctor and your child has been diagnosed with a fractured or broken bone, COA can complete fracture management care and even provide a second opinion.
We would be very interested in giving a second opinion on your child's diagnosis or even managing the follow up fracture care. Because of how fast the bones in a child begin to heal, it is important to make an appointment approximately five to seven days after the injury. If you have a CD of the X-rays that have already been taken, please bring them to the visit.
Likely, your child will be scheduled to see one of our physician assistants, who is under direct supervision of our pediatric orthopaedic surgeons. At COA, we utilize physician assistants to manage the lower acuity injuries; this allows us to provide quicker appointments at more locations for trauma care. The physician assistants all specialize in the care of fractures and are always supervised by a physician. Should a case warrant further physician input, the physician assistant will always consult a physician.
Your child will likely obtain new X-rays to ensure that the fracture has maintained its alignment. Considering what your child might have already been through with this injury and treatment, your child's anxiety could be high. Our radiology technicians only work with children and are quite skilled at getting a child to cooperate and even smile during an x-ray.
Based on the X-rays, your child may have a new cast applied. Like our radiology technicians, our orthopaedic technicians are also very experienced with children and will do a wonderful job at making the casting experience a pleasant one. Your child typically can choose the color of his/her cast.
In some cases, surgery may be recommended to help better align the bones. If this is the case, your child will be referred to one of our surgeons at the practice. All surgeries are performed at either Children's Healthcare of Atlanta at Scottish Rite, Egleston, or Meridian Mark, with an all pediatric staff and pediatric anesthesiologists.
FRACTURES IN CHILDREN DIFFER FROM THOSE IN ADULTS
There are six main ways in which pediatric bones differ from adult bones:
- Bones in children are smaller than those in adults. Many of the orthopaedic hardware and braces are designed for adults and do not accommodate children. There are techniques and implants unique to pediatric orthopaedic surgeons that will often allow rapid healing with little immobilization times and minimal surgical intervention.
- Bones in children are growing, and there are advantages and disadvantages of working with growing bone. Since bone is growing, the bone has a significant potential to remodel, meaning that it can realign itself over time. Therefore, it is okay in certain scenarios if the bone heals crooked because when the bone grows, it will straighten itself out with time. However, if the fracture occurs through the portion of the bone that grows, known as the growth plate (or physis), it can lead to significant deformity and growth disturbance.
- Children’s bones are more flexible than adults. As such, while adult bones break, sometimes children’s bones bend. Ironically, sometimes “bent bones” can be more difficult to treat than those which are clearly broken.
- Children’s bones heal more quickly than their adult counterparts. Since the bones heal more rapidly, and since the bones can heal more crooked, often times, pediatric fractures can be treated without any surgery to realign bones. For example, a fracture of the femur (thigh bone) in a child typically heals in six weeks, while the same fracture in adult may take up to six months to completely heal. Therefore, children are more likely to have fractures treated in a cast whereas adults often require surgery.
- Activity levels of children are often different than adults. Most adults don’t climb walls, jump off sofas, jump on trampolines, or ride scooters. Although adults may not listen to the doctor’s advice, children don’t listen to anyone’s advice! Thus, treatment plans need to accommodate the minds and desires of children. This often entails keeping a cast on until the fracture is completely healed since telling a child to “take it easy” will not be accepted well.
- In general, injuries occur at its weakest link, so adults often “sprain” their limbs, meaning that they have experienced an injury to a ligament. In children; however, the ligaments are stronger than the bones. Therefore, fracture patterns are often different in children than in adults. Children do not sprain their ankles – they break them! The most common non-operative fracture occurs in the forearm, and the most common pediatric fracture requiring surgery occurs just above the elbow.