If you're a parent, you've probably been there before. Your child comes home from the ball field or the ice skating rink and says something hurts. You'll need a doctor to know for sure if he broke a bone, but there are some things you can see for yourself that help you figure out what's going on.
You'll know it's a broken bone (also called a fracture) if pieces of a bone have pierced the skin. You'll hear your child's doctor call this an "open" fracture. He may also say it's "displaced," which means the bone parts aren't lined up the way they should.
Another type of break is called "non-displaced." In that case, the broken parts of bone are lined up correctly. This type of fracture is harder to identify.
Both kinds have some symptoms in common, like:
Pain. Your child may hurt when he tries to walk, lift something, or put pressure on a limb.
Bruising. You may notice this in the area of the injury, and your child may say it feels tender.
Swelling. Your child can also get bumps or other obvious changes in the way his limb looks.
Snapping noise. Your child may say that he heard this at the moment he was injured.
Numbness. This could be a sign of nerve damage near a break. A change in the color of his skin could mean the same thing.
Can't straighten. Your child may have trouble doing this in the area of his injury, like a damaged elbow, for example.
Can't move a limb like normal. This isn't always a sign of a fracture, though. And some children can still move it even if it's broken.
What You Can Do Right Away
If you think that your child has broken a bone, get medical help. Call 911 right away if the bone appears through the skin or you suspect your child's head, neck, or back was injured. Even if that's not the case, you should still see a doctor as soon as possible.
There are things you can do while you wait for help. If you can see the broken bone, make sure your child is lying down. Then put pressure on the area with a sterile, gauze pad or, if there aren't any nearby, a clean cloth. Don't try to push the bone back into place, even if it's hard to look at, and don't wash it.
If you can't see the bone, don't move the limb. Try to cut away or remove clothing around the injured area, but do it as gently as possible so you don't cause any extra pain.
Wrap ice or a cold compress in a cloth and put it on the skin near the injured area. This will make it hurt less. Don't do this in babies and toddlers because cold temperature can hurt their skin.
Make a splint to get the area more stable. To do this, pad the space around the break with soft cloth, then add a rolled-up newspaper or board to the limb. This surface should extend both below and above the injury. Wrap tape or bandage to keep the splint in place, but don't do it too tightly.
Sometimes a sling made out of a piece of a towel or piece of clothing will keep the limb or joint in place.
Don't give any food, drink, or medicine to your child in case he needs surgery. It's usually not allowed just before an operation.
What to Expect From the Doctor
If your doctor’s office is open, you can call him for advice about the best place to take your child. In some communities, the emergency department of a hospital is your best bet. In other places, urgent care centers can take care of your child. Your own doctor may be able to check for a fracture in his office, but it’s best to ask first.
Wherever you go, your child will likely need an X-ray to help with the diagnosis. The doctor will also ask how the accident happened, what symptoms you noticed, and your child's medical history. He may also check if your child can move the injured limb or joint.
Typically, an urgent care doctor or your pediatrician will place a splint on the broken bone and then have your child see a bone specialist, called an orthopedist, as soon as possible. That specialist will place a more permanent cast and have your child return in a few weeks to see how the injury is healing.
Fractures in the growth plate -- an area of soft tissue that helps in the long-term growth of bones -- may not show up on X-rays. The doctor may order an MRI or another type of scan to look for signs of damage. Once he's made a diagnosis, your child's doctor will talk to you about treatment, whether it's a splint, cast, or surgery.