Children bone fracture causes, types, symptoms, treatment, and prevention

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children bone fracture is the most concerning problem in parents daily life. bone fracture is the most common bone disease in the world. Before we start the explain the bone fracture in children, the parent should get some basic knowledge about bone anatomical structure and physiology.

Bone anatomy and physiology

The reason why people bone fracture, because of the variety of types, structure, and compound of bone in the human body.  The bone surrounded by special material layers named periosteum. There are abundance blood vessels and nerves all over the periosteum in order to supply nutrition and hormone. The periosteum contains bone cell named osteocyte. The real bone structure is beneath the periosteum. This is the gross structure of human body bone.

Bone anatomy - Children bone fracture causes, types, symptoms, treatment, and prevention

The bone cell has a special function that divided continuously to form a new bone. When the fracture happens, bone can repair the fracture area depended on this. The human bone has contained two parts. The outer part is the compact bone area. It contains a higher density of osteocytes. It helps to protect the inner part of bone and bone marrow.  The inner part contains a lower density area called cancellous bone.  It has another name is a matrix and looks like a hive. This structure can help increase bone stability and bone marrow protection.


Different between child bone and adult bone

From the chemical side, the composition of the skeleton is the glue fiber, calcium, phosphorus and other inorganic substances. because of this, bone not only is hard but also have the elasticity to carry more heavy object without fracture. In childhood, glue fiber is the main compound of the bone and the bone cell division is more active, so children bone has elasticity more than adults. It’s not easy to break. The main reason for children bone fracture is violence.


Causes of children bone fracture

  1. Direct violence.

The violence effect on bone directly causes the bone fracture. This fracture with different grade of soft tissue injuries like the bruise, cutting, and others. This violence like wheel hit out children shanks causes tibial fracture or fibula fracture. Other examples of direct violence include stick hit, fall down from bed or sofa, hit on desk or wall, or the human factor.

Fall down from bed causes children bone fracture
Fall down from bed causes children bone fracture
  1. Indirect violence.

The indirect violence caused by a jump down from higher place and foot on the ground. In this situation, the upper trunk of the body forward suddenly. It will cause a compression fracture in the thoracic and lumbar vertebrae. Another example falls down and hips landing in skating. Most of the children will use their arm and hand support themselves. But it will cause arm bone fracture easily.

Falls down and hips landing in skating causes of children bone fracture especially arm fracture
Falls down and hips landing in skating causes of children bone fracture especially arm fracture

Symptoms of children bone fracture

There are series symptoms will appear when bone break. There are two main symptoms of bone fractures, systemic symptoms and local symptoms. In addition to the fracture, there may be some systemic symptoms will occur.

Systemic symptoms of bone fractures

    1. Fever

      A large amount of internal bleeding with the bone fracture will cause edema around the fracture area. Body temperature will slightly rise when edema absorbed by the tissue. This temperature changing is generally not more than 1 degrees. But when temperature changing more than 2 degrees with open fracture should consider infection possibility.

    2. Shock

      The shock will happen in serious fracture cases like multiple fractures, pelvic fracture, femur fracture, spine fracture and critical open fracture. The shock happens because of extensive soft tissue injury, a large amount of internal bleeding, severe pain or visceral organ injury in children.

Local symptoms of bone fractures

    1. Edema

      When a fracture occurs, the periosteum, bone marrow, and peripheral tissue’s blood vessels rupture. It causes hematoma in the fractured area. The tissue around that area get an injury and formed edema at the same time.

    2. Ecchymosis

      A skin of the patient with bone fracture appears blue or purple ecchymosis around the injured area. The patient will feel pain when touching it. The pain will get severe when they move.

    3. Displacement

      Most of the fracture happens displacement. These include lateral displacement, angulations displacement, shortened displacement, rotation displacement and separation displacement. Sometimes two or three displacements happen on same fracture area.

    4. Patient limb activity is limited or appears abnormal activity

      Due to the swelling of the wound and pain, which will make the injured area cannot carry out the usual activities. Limb function has been limited. If it is a complete fracture, then the injured extremity will be completely unable to carry out any activities.


Treatment for children bone fracture

If an upper limb is swollen, painful, and restricted due to an outdoor injury, the child is likely to have a fracture. Parents should immediately bend the child’s injured upper limb 90 degrees to the chest for reducing bleeding and also use ice compression for reducing swelling; but must not knead swelling and hot compress, so as not to aggravate the child’s injury. Parents can use books, boards for simple fixation, and then go to the hospital for medical help.

There are two methods of treatment in the hospital that are the conservative treatment (plaster fixation) and surgical treatment. If there is an intraarticular fracture or obvious displacement cannot be reduced and the fracture cannot be kept stable after reduction, surgical treatment is needed.

At present, closed reduction minimally invasive surgery is used for long bone fracture in children widely. The advantages of this operation are a small incision, minimally invasive, scar-free, and a small amount of bleeding.


Prevention of children bone fracture

If parents want to avoid children bone fracture, they should need to pay attention to eliminate the hidden dangers of daily life. They also should enhance daily nutrition like calcium supplement for children at the same time.

  1. When playing outdoors, you need to raise your child’s awareness of self-protection. Make sure they wear helmets, elbow-pad, and kneepads when riding skateboards and bikes to avoid accidental falls.
  2. In crowded places, remind children not to push, not to run to the crowded area.
  3. When playing on an air cushion, do not let the child play on the edge of the mat to prevent slipping and falling.
  4. Pay attention to proper exercise, increase sunbathing, and dietary nutrition absorption(vitamin D, calcium intake).
  5. Place a thick carpet or blanket on the floor or lay a wooden floor to reduce the impact of a fall.

Healthyday.life reminder:  If the parents found that the child has systemic symptoms after fracture, it proves that the fracture is serious. Parent must carry out first aid immediately and take the child to the nearest hospital to take proper medical treatment.


 

References

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  • Written by Nurmemet, MD (Emergency Medicine Specialist)
  • Medically reviewed by Merhaba, MD (Pediatrician)

 

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