How To Recognize And Initially Manage Bone Fractures In Children

By in Health & Safety on 19 January 2009

As soon as your child becomes physically active and learns to risk for more daring experiences, he has a higher risk of having serious injuries such as bone fracture. Since their bones are still growing and supple, it could easily break, bend, or crack when considerable force is applied to it. This type of fracture is called greenstick fracture and occurs more commonly in children.

Both direct (heavy blow to your child’s leg) or indirect (e.g. twist or a wrench) force can cause bones to fracture. Fractures can be closed or open. In an open fracture, one of the broken bone-ends pierces through the skin surface; hence there is a visible wound with a protruding bone in it. This type of fracture is not difficult to identify but carries a high risk of becoming infected.

In a closed fracture, the skin above the fracture is intact. Though the bone ends do not pierce through the skin, it could be possible that it has caused damage to other internal structures surrounding the bone, like the major blood vessels inside. In such case, the child can have internal bleeding and shock.

To recognize fractures, there may be:
– pain and difficulty in moving the area
– swelling or bruising at the fracture site
– shortening, bending, twisting and other deformity of the extremity
– difficulty in moving the fractured limb
– coarse grating of the bone ends that can be heard or felt, but this should not be
intentionally sought
– wound with protruding bone ends
– signs of shock: rapid pulse which eventually become weak as shock progresses, pale &
cold clammy skin, weakness and dizziness, rapid & shallow breathing, restlessness, or

Fractures should be managed as soon as possible in the hospital. But before transporting your child with a fracture, the following must be done:

1. Immobilize the fractured part. If a fracture occurs in a limb, place padding such as towels, clothing, or cotton wool between the legs, between the thighs, or between the arm and the body (depending on the site of fracture). Then, tie broad-fold bandages or clothing at intervals along the limb, avoiding the injured site.

For open fracture, wound should first be covered with clean, non-fluffy pad or sterile dressing. (You may put on gloves first, if available before touching the wound). Then, carefully build up a padding on top and around the dressing, making sure not to press on the protruding bone. The dressing and the padding should then be secured with a bandage. Then, immobilize the fractured area as instructed above.

Important point: It is necessary to put padding between limbs so that the bandaging does not displace the broken bones or press bones against each other.

2. Check the blood circulation beyond the bandage every 10 minutes. If the circulation is impaired, loosen the bandages.

3. Without delay, arrange to transport the person to the hospital.

Proper initial handling of fractured bone is crucial to prevent further movement at the injury site and the possibility of infection. Otherwise, either or both conditions can delay healing and oftentimes, put your child in a life-threatening situation.


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