fracture healing in children

Overview

A fracture is a broken bone. In children, bones are still growing and are more flexible than adult bones, so they can bend and crack in ways that are different from adults. Fracture healing is the process the body uses to repair a break, and it usually happens faster in children than in adults.

Yes. Fractures are one of the most common injuries in children. Every year, many children break a bone, especially during play, sports, or falls.

Fractures can happen to any child, but they are more common in active children and teenagers, especially those who play sports, ride bikes, or climb playground equipment. Boys tend to have more fractures than girls.

Symptoms

Common symptoms

• Pain at the site of the injury, especially when touching or moving the area
• Swelling and bruising around the injured bone
• Difficulty moving the limb or putting weight on it
• A visible deformity, such as a bent or shortened limb
• A cracking or snapping sound at the moment of injury

Symptoms in children

• A child may cry, complain of pain, or refuse to use the injured arm or leg
• In a small child, a fracture may cause only mild symptoms, like limping or holding an arm still
• Sometimes a child can still move a slightly broken bone, so don't rely on movement alone to rule out a fracture
• Younger children may become fussy, lose their appetite, or seem unusually quiet

Symptoms in older adults

• For comparison, older adults with fragile bones often break a bone more easily, and their bones may take longer to heal
• An older adult may have less swelling and pain than a child, but any fall with persistent pain should be checked by a doctor

Causes

Main causes

• Falls from a height, such as from playground equipment or a bicycle
• Sports injuries, especially contact sports like football or rugby
• Direct blows or crush injuries from accidents
• Overuse injuries, where repeated stress causes small cracks in the bone

Risk factors

• Being very active and taking part in sports or rough play
• Not having enough calcium or vitamin D, which are needed for strong bones
• Having certain medical conditions that weaken bones, such as osteogenesis imperfecta
• Using safety equipment incorrectly or not at all, like not wearing a helmet when cycling

When to see a doctor

See a doctor urgently if:

• If the child has a suspected fracture, seek medical care right away
• If the injury is very painful, shows a deformity, or the child cannot bear weight
• If the child falls on an arm or leg and has swelling that quickly worsens

Book a routine appointment if:

• If the child is still limping or favouring a limb a few days after a mild fall
• If pain or swelling is not improving after a couple of days at home
• If the child has a fever or the area feels hot, which could be a sign of infection

Diagnosis

The doctor will ask about how the injury happened, examine the child, and check for pain, swelling, and movement. They will also check for any signs of nerve or blood vessel damage.

Tests that may be done

• An X-ray is the most common test to see if a bone is broken and how the pieces line up
• In some cases, a CT scan or MRI may be used to get a more detailed picture, especially for complex fractures or growth plate injuries
• Rarely, a doctor may take an X-ray of the healthy limb to compare

What to expect at your appointment

The child may be given a temporary splint before the X-ray to keep the area still and reduce pain. For mild fractures, the doctor may be able to tell right away and will then put on a proper cast or splint. For more complex breaks, you may be referred to a bone specialist (orthopaedic doctor).

Treatment

The main goal of treatment is to hold the broken bone pieces in a good position so they can heal straight and strong. In children, this often means a cast or splint. Pain is usually managed with safe pain relief, but always talk to a doctor or pharmacist before giving any medicine to a child.

Self-care at home

• Keep the injured limb raised (elevated) on pillows for the first few days to reduce swelling
• Apply an ice pack (wrapped in a towel) for 15–20 minutes several times a day as directed by the doctor
• Keep the cast completely dry — use a plastic cover or bag when bathing
• Do not poke sticks or any objects inside the cast to scratch itching — blow cool air with the help of a hair dryer on a cool setting
• Follow the doctor's advice about how much weight can be put on the leg or arm

Medical treatments

Treatment may include applying a plaster or fibreglass cast to hold the bone steady. Sometimes the doctor needs to gently move the bone back into place without surgery; this is called a closed reduction and may be done under pain relief or light anaesthetic. The child will have check-up X-rays to make sure the bone is healing in a good position.

When is surgery considered?

Surgery is needed if the fracture is badly displaced, if the bone pieces cannot be aligned by simple manipulation, if the fracture is open (the bone has broken through the skin), or if the fracture involves a joint or growth plate in a way that needs careful fixing. In surgery, tiny wires, screws, or plates may be used to hold the bone, and these are often removed later.

Living with this condition

While the bone heals, the child may need to take time off school and sports. Keeping the cast clean and dry is important. Your child may need help with daily tasks like dressing or washing, and you can encourage them to do quiet activities like reading, drawing, or puzzles. The doctor will tell you when the cast can come off and how to gradually return to normal activities.

Lifestyle tips

• Make sure your child follows up at all scheduled appointments
• Ask about physiotherapy or gentle exercises to help regain strength and movement after the cast is removed
• Encourage safe active play once the doctor says it's okay, with proper protective gear
• Avoid contact sports until the doctor confirms the bone is fully healed

Diet and exercise

A healthy diet supports bone healing. Offer foods rich in calcium, such as milk, yoghurt, cheese, and leafy green vegetables, and foods with vitamin D, like oily fish and eggs. Gentle exercise of other limbs is usually fine, but follow the doctor's guidance about resting the injured area.

Mental health and emotional wellbeing

A fracture can be frustrating for a child because it limits play and independence. Your child may feel scared, upset, or bored. Reassure them that the bone will heal and that they will get back to normal. It may help to talk about the healing process in simple, positive terms and to plan enjoyable activities that are safe with a cast.

Prevention

Not all fractures can be prevented, but many are avoidable. Encourage your child to wear proper safety equipment, such as helmets when cycling or skating, and knee and elbow pads when skating or scooting. Teach them how to fall safely and make sure playground surfaces are soft and well-maintained. Also, a healthy diet rich in calcium and vitamin D helps keep bones strong.

Complications

If left untreated

• The bone may heal in the wrong position, causing a crooked limb
• A growth plate fracture that is not treated may affect future bone growth and cause one limb to be shorter than the other
• An open fracture that is not cleaned and treated can lead to a serious infection in the bone
• Without proper immobilisation, the fracture can move out of alignment, which may require more invasive treatment later

Long-term outlook

The outlook for a child with a fracture is excellent. Children's bodies are remarkably good at healing bone, and because their bones are still growing, they can often 'remodel' (straighten out) minor residual deformities over time. Most children recover completely and return to all normal activities after the bone has healed and any rehabilitation is complete.

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