When it Comes to Fractures, Children Need Special Attention

By Guest Blogger John Frino, MD, associate professor of pediatric orthopaedic surgery, Brenner Children’s Hospital

The carefree, playful days of summer give kids plenty of opportunities to be active and adventurous. As a result, the risk of accidents also increases. That’s why pediatric orthopaedists see more patients with fractures during the summer months than any other time of year. Fortunately, knowing what to do—and where to go—when your child gets injured can help you ensure he or she gets the best possible treatment.

Determining if it’s an Emergency

Kids tend to get a lot of bumps and sprains, and these things usually resolve themselves. If an injury produces pain and swelling, and prevents the child from bearing weight on a particular limb, there’s a good chance he or she needs an X-ray. However, this is usually not a concern that requires an emergency department visit.

Typically, you can wait until the next day to have your child seen by a doctor. During this time, you can ice the injury, give your child an over-the-counter pain reliever like children’s Ibuprofen, and ensure your child gets adequate rest. If the injury is still just as swollen and painful the next morning, you should make an appointment for your child to be seen as soon as possible.

If the injury has created an obvious deformity in your child’s arm or leg, don’t wait overnight; he or she needs to be seen right away.

Seeing the Right Doctor

Your pediatrician can let you know if an X-ray is needed. However, making primary care your first stop can delay diagnosis and treatment. Many pediatricians’ offices don’t have the ability to perform X-rays. So, they would have to send your child elsewhere for the X-ray, then wait on a radiologist to return the test with a diagnosis. The pediatrician would then refer you to an orthopedist for treatment options, such as splinting or surgery.

If you go directly to a pediatric orthopedist, however, the process will be expedited. We have in-facility X-rays at Brenner and don’t have to rely on a radiologist to interpret the results. And, once the results are determined, we can proceed with treatment. Most health insurance plans will allow you to visit a pediatric orthopedist without a referral from your child’s pediatrician.

Addressing Concerns Specific to Children

In selecting an orthopaedist for your child, it’s ideal to choose a pediatric orthopedist. All board-certified orthopaedists, including adult orthopaedists, have had some training in treating simple fractures in children. However, pediatric orthopaedists have special experience and training in treating children.

Children aren’t little adults. They’re constantly growing and changing. Growth plates (cartilage at the ends of long bones) are one of the unique features children have that can affect the treatment of a fracture. On one hand, a fracture close to the growth plate can mean more potential to remodel the bone. We can put the child in a cast, and it will heal and straighten out over time. On the flip side, certain growth plate fractures, such as those around the elbow, need to be watched more closely and treated more aggressively.

Pediatric orthopaedists are also comfortable working with children. We have staff and technicians who see children all day, and know the things to say and do to reduce their anxieties. We’re also more in tune with children’s lifestyles. For example, we know a kid on summer vacation is going to need a waterproof cast so that he or she won’t miss out on summer activities. When it comes to treating children, the little things add up.

Remember: Visit Brenner Children’s Hospital Emergency Department or another emergency facility if your child has an injury that has created an obvious deformity. For any other fracture-related concerns, feel free to contact Brenner Children’s Hospital Orthopaedic Surgery at (336) 716-8094 during office hours or Wake Forest Baptist Health on Call at (336) 716-2255 after hours for an appointment with Dr. Frino or one of his associates.

*Sponsored By Brenner Children’s Hospital

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