Kids can suffer sprains and broken bones at any time of the year. Whether an injury occurs from sledding or from a fall walking across an icy driveway, unless you are blessed with the powers of Superman and his X-ray vision, you won’t be able to determine whether it’s a broken bone or if it is just a sprain. That being said, there are many clues that can help steer you toward a probable diagnosis.
One characteristic that makes children different from adults — and even more challenging to diagnose in terms of injury — is that they have growth plates at the end of all the long bones. These growth plates are formed of cartilage and are prone to injury, as they are weaker than all the other structures that support the skeleton (bone, ligaments and tendons). Because of this weakness, growth plate fractures are common in children and can occur even with typical sprains and strains.
Bruising is one sign that does little to help differentiate between fractures and sprains, because bruising can be caused by either injury.
If your child has sustained a break, you may hear that the fracture is displaced, meaning the bone ends do not line up; or it is nondisplaced, meaning that the bonse are lined up. You may also hear that the fracture is open, if the bone is showing through the skin; or closed, if there is no break in the skin. The fracture may also be comminuted, meaning that it broke into more than two pieces.
In terms of getting injuries evaluated by a health care professional, all injuries that involve deformity, an inability to bear weight or use an upper appendage, or significant swelling should be checked. This is especially true for children with open growth plates — namely every child who hasn’t finished growing. An X-ray remains the best way to check for fractures and assess the growth plates in the area of injury.
If you think your child has sustained a break or major sprain, he or she may need immediate medical attention from a primary care provider or your local emergency department. Mount Nittany Physician Group Pediatrics has offices in Boalsburg and Bellefonte. To learn more, visit mountnittany.org/physician-group.