PEDIATRIC FRACTURES

Fractures in children are significantly different then they are in adults.  Children have a membrane which covers the bone called a periosteum.  The child’s periosteum as opposed to that of the adult periastium is thicker.  It has active cells, which make bone, contained in it, has a very rich blood supply.  Therefore children are able to heal their fractures much more rapidly than adults and can remodel or correct for any residual deformity.  This means that in general children have some tolerance for residual angulation and displacement, which can’t be compensated in an adult.

The pitfall in children’s fractures is the closeness to their growth plate.  At the end of each long bone a child has a soft cartilage growth plate.  At the end of each long bone a child has a soft cartilage growth plate.  This growth plate is sensitive to trauma or injury.  On occasion, it can close or partially close, which means it can stop growing.  This would leave the child with a shortened bone or more commonly an angular deformity of the arm or leg.  If this were to occur it can be corrected at a later date.

Children’s fractures are typically immobilized in a cast for the full period of healing.  It is rarely necessary to send children to physical therapy after their fractures heal.  Joint stiffness in children is quite uncommon, whereas in adults it is of much greater concern.

Once your child’s fracture heals, the cast will be removed and normal use of the extremity will be all that is required to restore function.

Occasionally, with very severe or unusual injures it may be necessary to operate in order to realign the fracture pieces.  This is typically done in fractures about the elbow and in specific fractures adjacent to joints, as well as some of the growth plate fractures mentioned above.  Once the fracture heals and the cast has been removed your child can resume normal activity on a graded basis.  This means that it is important that relative normal range of motion has been restored to the adjacent joints before strenuous physical activities is begun.