Kids’ Fractures: Can You Catch a Break?

Children can suffer bone fractures without even their parents knowing it.

That can be a frightening situation, but knowing what to look for when you child complains after a fall or  injury, and understanding the importance of proper diet with sufficient calcium and vitamin D, can contribute to proper bone health in your toddlers and older children.

Bone fractures of the extremities are quite common in otherwise healthy children.

But sometimes it can be hard to tell if your toddler or older child has a fracture, particularly if you didn’t hear a snap or there’s no obvious bend in the limb.

“Parents should look carefully at their child after any fall or injury, and see if there is any swelling,” said Pooya Hosseinzadeh, M.D., a pediatric orthopedic surgeon with Baptist Children’s Hospital, whose specialties include fractures, spine care and sports-related injuries.”If the child has a limp and complains of pain for more than 48 hours, then they should definitely be checked.”

What Parents Should Look for

A good example is an elbow injury, which is relatively common. Sometimes a diagnosis of a fracture can be difficult because a substantial part of the elbow is composed of cartilage, which does not show up on X-rays, said Dr. Hosseinzadeh.

“How obvious a displacement depends on how much soft tissue there is,” he said. “Some of the displaced fractures which occur in the upper arm close to the elbow in very young children are easy to miss from the excess of soft tissue fat.”

Other common injuries in children are stress fractures in the foot or leg, potentially from overuse. Kids who play soccer or other sports can be especially vulnerable.

“Stress fractures, which are not complete fractures, present themselves as prolonged pain in the foot or leg, but not from a single injury or incident,” Dr. Hosseinzadeh said. “If a child complains of pain in the leg or foot for a prolonged period of time, or at least 48 hours, parents should have their child checked out.”

Here are signs of a possible bone fracture in your child:

Swelling and bruising;

Persistent pain in one limb or spot;

Tenderness to the touch;

An inability — or unwillingness — to move a limb (However, a child could still have a fracture even if he or she can move the limb.)

Bone Health in Children

While kids’ bone fractures are often inevitable, there has been a significant increase — up to 50 percent according to some studies — of childhood fractures over the past four decades, said Dr. Hosseinzadeh.

That time frame coincides with the obesity epidemic in children, he said. The result is that many children don’t get enough of the vitamin D that is essential for proper growth and texture of bones.

What’s causing this deficiency? For one, the growing trend of sedentary children, who would rather play video games than play outdoors, is a big factor.

Known as the “sunshine vitamin,” vitamin D is produced by the body in response to sunlight.

It also occurs naturally in some foods — including some fish, fish liver oils, and egg yolks — and fortified dairy and grain products.

Vitamin D is essential for strong bones because it helps the body use calcium from the diet.

Moreover, vitamin D deficiency is associated with obesity.

“I want parents to know that if your child has a second fracture, or breaks a bone from a minor incident, to get their vitamin D levels checked. A vitamin D deficiency is easily treated,” said Dr. Hosseinzadeh.

The other big factor in increased bone fractures is the tendency of kids to take up sports at a younger age, which explains why there are more stress fractures from overuse.

“We definitely have seen an increase in all types of fractures in children,” Dr. Hosseinzadeh said. “But sometimes I see that treatment has been delayed by as much as three to four days because parents didn’t realize that there was a fracture.”

Tags: Baptist Children's Hospital, bone health, healthy habits