Broken Wrist In Children

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Last Medical Review: March 28, 2020
Medically Reviewed by Dr. David Costa Navarro
Wrist Fracture in Children (March 28, 2020)
What is a wrist fracture? (March 28, 2020)

Children can injure the wrist when they fall and receive themselves with the hand. Children who have broken the wrist receive plaster joints. Sometimes an operation before the plaster is also needed to repair the damaged legs.

It usually takes between six and eight weeks from the injury to the child, until the child can work out or take part in sports lessons at school again.

Symptoms

When the child has injured the wrist it hurts, and the child usually does not want to use the hand. Often there is a visible swelling around the wrist.

When and where should I seek care?

If the child has fallen and is very sore, or does not use the arm, contact the healthcare provider. Since the skin is usually undamaged, it is not possible to see how serious the damage is. To find out, the child must be examined. Contact a health care center or emergency room.

You can always call and get medical advice at telephone number 911. Then you can get help to assess symptoms or help with where you can seek care.

What can I do for myself?

To relieve the pain, you can wrap the baby’s wrist with an elastic bandage, or let the child’s hand and arm rest in a so-called mitella. You can make a mitella yourself by folding a shawl into a triangle and tying it behind the child’s neck so that the forearm can rest in the fabric, just above waist height. Most importantly, it feels comfortable for the child.

Sometimes the child may need to be anesthetized during treatment. Therefore, it is important that the child does not eat anything before. The reason is that the baby may otherwise vomit during anesthesia, which may cause the contents of the stomach to reach the lungs and cause respiratory distress. If the child has recently eaten, treatment may need to be postponed until the risk of vomiting is over.

Although the child must be fasting, you can give non-prescription pain-relieving medication containing paracetamol, such as Alvedon or Panodil. The drugs are available in different forms and the dose is adjusted according to the child’s weight. There are instructions on the package. If you give your child tablets by mouth, rinse them with only a small amount of water.

The injuries can be difficult to prevent

It is difficult to prevent arm and leg fractures, as this is usually the result of an accident. Slightly larger children can use special protection for their wrists when they, for example, go in-line or snowboard.

Investigations

The doctor examining the child feels on the wrist and forearm to examine where it hurts, if it is swollen and if it hurts when the child bends on the wrist.

If the doctor suspects that the wrist is broken, an X-ray examination is performed. Then the child may place his forearm still on a special x-ray table. Then at least two x-rays are taken, partly when the child has the palm down and partly when it has the little finger side of the hand against the table. This way you get two pictures that show if the skeleton is damaged and if there is any fault. The doctor then decides which treatment is needed.

It doesn’t hurt to take x-rays. However, it can hurt when the doctor bends or stretches the wrist. As a parent, you can be present throughout the investigation, but you must have a protective apron or leave the room just when the x-rays are taken.

Sometimes it can be such a small crack in the skeleton that it is not visible on the X-ray. If the doctor still suspects that the leg is broken, the child is often treated as if it were broken. After just over a week, the child may come back for a new x-ray examination. If there is no bone fracture in this examination either and the pain has decreased, the treatment can usually be terminated.

Treatment

How the wrist injury is treated depends on where the injury is and how it looks. Above all, the treatment may differ depending on whether the leg is wrong or not.

When the child grows, wrong positions are usually corrected

If the child has sustained an injury right next to the wrist, the skeleton can have fairly large defects without having to be corrected. This is because the skeleton rebuilds as the child grows, so after half a year it is no longer possible to see any fault.

This type of injury is therefore usually treated by giving the child a plaster rail from the knuckles up to the elbow. The rail is on the clock for three to four weeks. In some cases, the plaster may need to go all the way up to the shoulder. After that, sometimes a rail is needed during the day for another week.

The wrist is plastered

When the wrist is to be plastered, the doctor first measures the child’s arm to see how much plaster bandage is needed. Then, several layers of wet plaster are laid on a layer of wadding. This plaster rail is then placed on the arm and held in place by elastic bandages.

Sometimes so-called circular plaster, usually plastic plaster, is used that goes around the entire forearm.

Sometimes the crime must be rectified

Sometimes the mistake has to be corrected. It is called that the wrist is exposed. Then the child is usually anesthetized, thus getting anesthesia. Before sleeping, it is important that the stomach is so empty that the child does not risk vomiting during anesthesia. This is why you should not give your child something to eat or drink before going to the hospital, except possibly pain-relieving medication.

When the child is asleep, the doctor, who is usually an orthopedist, can correct the mistake.

Sometimes the fracture can be repaired immediately after the crime has been stunned, and the child has been treated with nitrous oxide. Since it may take time to get to surgery, this can be a way to save time for the child.

Sometimes metal pins are needed

Once the injury has been rectified, the doctor assesses whether the position of the fracture feels stable or whether the injury also needs to be stabilized with metal pins.

If the damage has to be stabilized with metal pins, the doctor first makes small holes in the skin. Then long metal pins are inserted through the holes and inserted into the leg. Usually two pins are needed. A small part is left outside the skin, so that the pins can easily be pulled out later.

The operation ends with a plaster arm

When the position is stable, the child receives a plaster joint in the same way as described above. Most often the child receives a plaster bandage from the knuckles up to the elbow.

When the operation and plastering is complete, the child is driven to his/her bed in a so-called awakening ward. There the child is allowed to lie down until they awake properly, which can take up to a couple of hours. A parent or other relative may sit next to the bed for the time being. Some children may feel ill after waking up.

Usually the child can go home the same day

Usually, the child can return home from the hospital a few hours after surgery or plaster. Sometimes the child needs to stay in the hospital one night after surgery. An x-ray examination must be done before the child is allowed to go home, unless x-ray was done in connection with the operation.

It is important that the hand is held high during the first few days, so that the arm and hand do not swell. Pay attention to whether the baby gets swollen or blue fingers. It is a sign that the arm is swollen and that the plaster is too tight. In the first instance, try a proper high position, but if this does not help, you should contact the emergency room or the medical center where you were treated.

The first few days after the operation, the child may be in pain and need some form of analgesic containing paracetamol (Alvedon or Panodil). It is also good if the child tries to sleep with his arm on a pillow for the first nights.

The child may need to be home a few days after surgery.

The child has a relationship for a few weeks

The child usually gets plaster bandages around the clock for three to four weeks. Sometimes they then have a rail during the day for another week. Most often, an x-ray check is done just over a week after the child has received a plaster.

Metal pins are usually allowed to remain for about four weeks. It usually does not hurt to pull out the pins and it can usually be done without anesthesia. Once the pins have been pulled out, the child can get his plaster rail back for another one to two weeks.

If the injury is not complicated, the parents can remove the child’s plaster rail themselves and only come back if there are any problems.

Good to touch your fingers

If the child gets a plaster, they may find it exciting for a few days, but then it can be painful. After a while, for example, it may begin to itch under the plaster. The plaster also impedes mobility.

It is good if the child touches his fingers properly while the arm is plastered, so that his fingers do not swell and become stiff. Otherwise, it can make recovery more difficult when the plaster is removed.

The dressing must be protected from water

Children who have plaster should not bathe. The shower goes, but the dressing must be protected from water because the plaster is loosened by water. A dressing with plastic plaster is not destroyed by water, but the hydrogen stays inside the dressing and that makes the skin not feel well. There is a risk of fungal infection.

The pharmacy has special plastic covers that can be used when the baby is showering. You can also use a dense plastic bag.

The child may need help when showering or to access all places on the upper body with, for example, a washcloth.

If the plaster breaks

If the plaster breaks, it can be repaired or replaced. If the plaster has broken, first contact the reception where the child was treated.

When it’s time to remove the plaster

Some children may find it unpleasant to remove the plaster. If it is a plaster that surrounds the entire arm, the plaster must be sawn with a special saw. It does not hurt, but can give a vibrating feeling and is experienced as a little scary. Once the heavy bandage has been removed, it can feel as if the arm is floating in the air by itself.

Usually, no movement training is needed afterwards

Once the child has had the plaster removed, the doctor examines whether the wrist appears to have healed, if more visits are needed, and for how long the child must refrain from sports.

The child cannot always use the arm at one time when the plaster is removed. It takes time to get used to being free of plaster and to bend and stretch the joints again. But it is extremely rare that a wrist injury in children needs special training when the plaster is removed. The daily movements that the child makes when, for example, getting dressed, eating and playing are usually fully sufficient for the child to regain strength and mobility.

It usually takes between eight and ten weeks from the time of injury until the child can attend sports lessons at school again.

What happens in the body?

It is common for children to injure the wrist or forearm as they fall and receive themselves with the hand. Most injuries of this type affect the lower part of the forearm, including the wrist.

There are two legs in the forearm. It is the jet leg, which goes from the elbow down to the wrist on the same side as the thumb, and the elbow leg, which goes from the elbow down to the wrist on the little finger side. In the case of injuries in the middle of the lower frame, both legs are usually injured, while it is more common that only the beam bone is injured when the injury is down at the wrist.

Children receive injuries other than adults

Both children and adults can have broken arms and legs, so-called fractures, in the event of an accident. But the growing child skeleton and the adult, ready-made skeleton suffer different types of damage.

Some differences between children and adults:

  • The muscles attach to the skeleton with tendons. In children, the skeleton is softer and more porous than the tendon and tendon. Therefore, when children fall into an accident, the tendon or muscle does not break, but they more often suffer a skeletal injury than adults.
  • Because the skeleton is softer, children sometimes suffer injuries where the skeleton is not broken off as in adults, but only bent. These injuries are treated as normal fractures.
  • As children grow, parts of the skeleton are softer and more porous than the other skeleton. Here the child can get displacements, so-called epiphysiolysis. These injuries are also treated as common bone fractures.
  • The child’s skeleton rebuilds as it grows. Therefore, misalignment after arm and leg fractures does not always have to be operated or corrected. In children, the wrongs are rectified by themselves, while adults who have the same wrongs usually have to be treated.
  • Healing is much faster in children than in adults and therefore the treatment time is shorter.

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