Kid & Teen Fractures: Everything You Need to Know
Kids will be kids, and teens will be teens. Whether they are an avid sports player, are clumsy on the playground, or don’t think before they jump, it’s common for kids & teens to have fractured a bone while in elementary, middle, or high school. As many as 40 percent of girls and 50 percent of boys experience a fracture during their childhood. It’s also true that the 11-15 age range is more likely to experience fractures because this range is during a pubertal growth spurt and the number of minerals needed to keep the bones strong can’t keep up with how fast the bones are growing. Needless to say, if your child or teen is experiencing a fracture, they are not alone, and this is a very common occurrence.
Child & teen fractures are usually not a cause for major concern, as they can be treated easily by an orthopedic surgeon. Often, most of these fractures need a simple cast in order to mend the bone. Today, we’re going to discuss why adolescent fractures are different from adult fractures, and why they’re often treated as such. Then, we’ll discuss the most common type of fractures, along with the relation between sports medicine and adolescent fractures, since it has been found that increased participation in competitive youth sports has led to a rise in pediatric overuse injuries, such as stress fractures.
The Difference Between Adult and Adolescent Fractures, Including How They Are Treated
Because adults are done growing by the time of their fracture, there are some obvious changes to the way an adolescent fracture would be treated. Children and young teenagers are constantly growing, so their fractures must be treated in a way that won’t affect their growth plate and joints in a negative way, or keep their body from growing in a safe and healthy way.
In boys, their biggest growth spurt is usually around the ages of 12 to 15, although they can begin growing as early as 9 and can grow until they are age 19. Sometimes, in rare occurrences, men can grow until they are 25, although these growths and changes are very minor.
For girls, most stop growing at the age of 14 or 15, or a couple of years after menstruation begins. Puberty begins earlier in women than in men, and their biggest growth spurt happens between 10 to 14 years old. After their first period, they’ll probably only grow one to two inches.
Because of this range of time in which your child or young teen is still growing, their fracture will be treated differently than it would be if you were to have the same exact fracture. This is because you are no longer growing, so your recovery can’t stand in the way of important developmental changes in your body. According to this study, your child’s fracture and treatment should be analyzed according to these 8 factors: age, weight, type of fracture, bone segment, available equipment, own experience, postoperative management, and cost-effectiveness.
When it comes to figuring out the correct treatment, it is important for the orthopedic doctor to take note of the patient’s background and medical history. If your child or teen has had several fractures, there is a chance they may have a medical condition associated with an increased risk of fragility fractures. The list of the possible medical conditions is long and includes:
- Genetic disorder
- Chronic inflammatory conditions
- Conditions relating to reduced mobility
- Infiltrative conditions
- Endocrine conditions
- Nutritional/malabsorptive conditions
- Renal conditions
- Iatrogenic conditions
This list includes:
- Osteogenesis imperfecta
- Osteoporosis pseudoglioma syndrome
- Ehlers-Danlos syndrome
- Marfan syndrome
- Hajdu-Cheney Syndrome
- Polyostotic fibrous dysplasia
- Rickets (genetic forms)
- Idiopathic juvenile osteoporosis
- Chronic inflammatory conditions
- Systemic lupus erythematosus
- Inflammatory bowel disease
- Nephrotic syndrome
- Cerebral palsy
- Duchenne muscular dystrophy
- GH deficiency
- Cushing syndrome
- Diabetes mellitus
- Female athlete triad
- Vitamin D deficiency
- Celiac disease
- Biliary atresia
- Cystic fibrosis
- Anorexia nervosa
- Chronic kidney disease
- Secondary hyperparathyroidism
- Radiation therapy
Don’t let this list overwhelm you. Your orthopedic doctor at Integrated Orthopedics will be able to help you diagnose your child if they seem to have any of these conditions. If this is your child’s first-ever fracture, this list is not something you need to be concerned about. If your child has had several fractures over a few years, even if they are highly active and participate in high-speed sports like skateboarding, biking or a competitive sport, your doctor will walk you through the diagnosis process. Only then, should you be concerned about your child’s health. One, or even two fractures in a few years, should not concern you and can be cared for by your orthopedic doctor with a high likelihood of no complications.
Treatment will also depend on the placement and type of fracture. Depending on if the fracture is displaced or not, surgery may not be necessary, and a cast might be enough to fix what was broken. Though, if the bone is displaced, especially if the fracture is open (pierced skin), surgery will be needed to decrease the risk of infection, along with putting the bone back into place. Most adolescent fractures are what we call greenstick fractures, which is named because it is similar to the breaking of a greenstick of wood (aka it doesn’t break all the way through). Children often experience greenstick fractures because children’s bones are more flexible than adults. Let’s look at the most common types of fractures in adolescents, and how each type is treated.
Most Common Fracture Types & Their Treatments
We’re going to look at the most common types of fractures in children and teens, along with some other common terminology used when describing a fracture. This vocabulary will help you when you’re communicating with your orthopedic doctor:
- Open (compound) fractures: This is the type of fracture in which the bone pierces the skin. Most of the time, these fractures are aggressive and will need immediate treatment in order to decrease the risk of infections.
- Closed fractures: This is the type of fracture in which the bone does not pierce the skin. This is the type of fracture that can usually be treated without surgery, as long as it is not displaced. If the bone is not displaced, but only fractured, it can be repaired with the use of a cast for an elongated stretch of time.
- Displaced fracture: When a bone is displaced it means that the bone fragments on each side of the break aren’t aligned, which may even require surgery to fix. Basically, the bone is displaced from where it is supposed to be, and surgery can help get it back in place.
- Comminuted fracture: Instead of the bone being displaced, the bone is actually broken into many different pieces. This also requires surgery and cannot be fixed with a simple casting.
- Greenstick fracture: As aforementioned, this is when a bone cracks but doesn’t break all the way through. These are the most common in children and might be what your child is going through because children have more flexible bones than adults.
- Buckle (torus) fractures: This is the type of fracture that happens when one end of the bone is compressed which causes the other end to buckle. This is also common in adolescent fractures.
If you think your child might have a medical condition listed above, here are three types of fractures that they might have:
- Low impact & Fragility fractures: Low impact or fragility fractures occur under low impact situations, such as falling from standing height, stepping too heavy, falling off of a chair, or another common activity. These fractures, along with recurrent fractures are often tied back to a medical condition, because the fragility of the bone led to a quick fracture, even though the situation was so low impact. If this happens to your child, share this information with your orthopedic doctor to discuss treatment options, along with determining if your child has a medical condition from the above list.
- Recurrent fractures: Much like low impact and fragility fractures, recurrent fractures are another sign that your child might suffer from an undiagnosed medical condition. Even if these fractures are from high-impact situations, like from a high fall, sports injury, car accident, or something similar, it may still be a sign. Obviously, there are situations in which a child endures several fractures in a row that are not related to a medical condition, but it doesn’t hurt to discuss this with your doctor, just in case. Children and teens are often more reckless than adults, so several fractures can be common in childhood, albeit stressful for parents.
- Vertebral compression fractures: Unless your child often has suffered from significant trauma to the back, one or more vertebral compression fractures could be a sign that your child has osteoporosis or metabolic bone disease.
- Humerus or femur fractures: The humerus and femur bones are long and strong bones that don’t often break easily unless the injury is severe. If your child has broken their humerus or femur, this might be a sign that you should ask your doctor for further testing and questioning.
More than 3.5 million children ages 14 and younger get hurt annually playing sports or other recreational activities. And beyond that, most organized sports-related injuries (62 percent) occur during practice. If your child has a sports-related fracture, fear not. These types of injuries are so common, and the team at Integrated Orthopedics is well equipped to help. Here you will receive innovative and evidence-based sports medicine care from a team of highly qualified healthcare professionals with specialties in orthopedics, podiatry, pain, and sports medicine.
When it comes to fractures and what sports are most common to induce them, here’s a list of sports that cause the most injuries in children:
- Baseball and softball
- Ice hockey
- In-line and roller skating
- Sledding or toboggan
- Snow skiing or snowboarding
Having your children participate in sports has many benefits. If your child is very active and participates in any of the sports above, there are some risk prevention strategies that can help. Here are some things we recommend:
- Preseason physicals: Before your child starts their season, head on over to Integrated Orthopedics and have them get a preseason physical. Once your child has gotten a physical, your doctor can evaluate how they can safely navigate their season.
- Variety of sports: Sometimes, fractures and other sports injuries are caused by overuse, and one simple way to help this is by having your child try out a variety of sports. This way, they are not overusing the same muscles on their body, and their entire bodies are getting exercise.
- Warming up/stretching: You should make sure your child is aware of how important warming up and stretching before and after is. If they are not properly stretched and warmed up, this can cause them sports injury.
- Hydration: Hydration is generally important for all people, but especially important for young athletes. Make sure to send your child to practice and games with an ample amount of water.
- Recognize injury as soon as possible: If your child has an injury of any sort, it’s best to reach out to your doctor right away. Even if it seems minor, it’s best to listen to your children’s concerns and bring them to Integrated Orthopedics right away. Something small can easily turn into something larger if not treated quickly.
If you need help diagnosing and treating an adolescent fracture, you should get in touch with a podiatrist immediately. We encourage you to reach out as soon as you can, whether you think your injury is severe or even a simple sprain. Integrated Orthopedic has a team of experienced doctors who have a background in helping with fractures in adults and children.
We encourage you to reach out after an injury your child experiences, so they can walk you through your next steps, based on your situation and the severity. If you are interested in booking an appointment with Integrated Orthopedics, use the contact form today.