Summer can be a time of great fun; it also can be a time of many a broken bone, especially for kids who are in the kindergarten and early elementary school age group.
For older kids, summer sports also can make a trip to orthopedics part of the “What I did last summer” essay.
Kids can be a challenge for orthopedists because sometimes a broken bone won’t be obvious. There might not be visible swelling or a deformity like you would find in an adult because kids’ bones are softer than adult bones.
“If I broke my arm, it would be swelling up,” says Dr. J.P. Rodriguez, an orthopedic surgeon specializing in sports medicine at Texas Orthopedics Sports & Rehabilitation Associates in Austin. “They can break them and it won’t swell as much ... it won’t look as crooked.”
A good test, Rodriguez says, is to compare the two sides of the body: the wrist you suspect might be broken versus the wrist you think is normal.
That’s the test Rodriguez asked his daughter’s school nurse to use when his daughter fell off a slide. Her wrist didn’t look broken until you compared it to the other wrist. Then the nurse could see that the bad wrist didn’t curve inward like the other one did. “Well, that’s broken,” he says.
Kids often don’t feel as much pain as adults do, too, but if a kid is complaining of pain an hour later, that’s usually an indication that something is wrong and he should be seen by a doctor.
Rodriguez recommends going to either the emergency room or an urgent care clinic at an orthopedics office. The reason is that those places will have a radiologist who specializes in reading fractures on X-rays and a pediatric orthopedist on call.
It depends on where the break is as far as how fast you need to get there, Rodriguez says. An elbow is something that needs to be fixed within 24 hours, whereas a wrist can wait a while. You’re not expected to know which bones need that immediate attention. When in doubt, try to get there within a day, certainly within that first week.
The big reason is the growth plate. Fractures in which the growth plate has been displaced need to be corrected within the first two weeks or risk causing further damage, Rodriguez says.
If you don’t happen to go to a children’s hospital or orthopedics urgent care clinic, make sure you get a copy of the X-rays, not just the report, and see a specialist within that first week to make sure nothing was missed.
You can’t entirely protect your child from broken bones, Rodriguez says. The worst break he’s seen recently was a girl who was just running across her yard and tripped.
“You want your kid to be able to play,” Rodriguez says. “You can’t protect them from everything.”
However, there are some things he calls “no-brainers.”
• Wear bike helmets when riding bikes or scooters, and make sure those helmets fit. He often sees kids wearing ones that are too big. Look for an extra small size if your kid is young.
• Supervise play on the playground. Make sure kids are using the equipment correctly. Even if you think your kid is big enough to jump off the slide, your big kid is modeling behavior for little kids who are not big enough to jump off a slide. Those little kids can get hurt.
• Don’t slide with your child in your lap. There’s something called a toddler’s fracture, which happens when a child is in your lap and his leg catches on the edge of the slide, and your adult-size momentum keeps going in the opposite direction. The force of your momentum can break the child’s leg. Instead, stand at the edge of the slide and guide the child down or be ready to catch him at the bottom.
The good thing is, kids heal quickly. Often it’s about four weeks in a cast and they are back to normal. If they are in a cast, watch out for numbness or color changes to the skin in that area. That warrants another trip to the ER.