Damage To The Ankle In Children

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Last Medical Review: March 28, 2020
Medically Reviewed by Dr. David Costa Navarro
Ankle sprains (March 28, 2020)

Children can injure the ankle when walking or running. This can happen, for example, when the foot is rotated rapidly, such as during a twitching or a prickling. Bone fractures in the ankle are more uncommon.

An injured or broken foot usually heals in one or a few weeks. If the skeleton is damaged, the child may need plaster casts. In severe injuries, surgery may be necessary.

Symptoms

When a child has injured the ankle it hurts and they often do not want to support the foot. Swelling, redness or bruising are usually common symptoms.

The injury does not have to mean that the bone is broken. Instead, it can often be, for example, a crunch or a prick. Wreckage and sprains do not need to be treated, but go by themselves.

When and where should I seek care?

If the child has fallen and does not want to support the foot or has a lot of pain, you should seek care directly at a medical 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 in the acute phase, it is good if the child receives an elastic bandage that helps stabilize the ankle. It is also good if they avoid supporting the foot and keeping the foot high to avoid continued swelling.

When the child injures the ankle, they sometimes need to be anesthetized during treatment. Therefore, it is important that the child is not given anything to eat and drink as there is otherwise a risk of being vomited during the anesthesia and that the contents of the stomach end up in the lungs causing respiratory distress.

Although the baby should be fasting, you can give a 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 or in the package leaflet. If you give your child tablets by mouth, rinse them only with a little water.

Difficult to prevent this type of injury

It is difficult to prevent arm and leg fractures that occur when children are playing.

Investigations and investigations

The doctor examining the baby feels on the ankle to find out where it hurts and where it is swollen. Depending on where on the ankle the child is in pain, the doctor is usually able to determine if it is a wreck or if the skeleton has been damaged.

The doctor x-rays the ankle

If the doctor suspects the skeleton is damaged, an X-ray examination is performed. Then the child may place his foot still on a special x-ray table. Then some x-rays are taken that show if the skeleton is damaged and if it has any malfunction. The doctor then decides which treatment is needed.

It doesn’t hurt to take x-rays. However, it can hurt when the doctor feels on the foot. As a parent or close relative, you can participate in the entire investigation. But you have to have a protective apron or go out of 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 bone 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 study either and the pain has decreased, the treatment can usually be terminated.

Treatment

The treatment of an injured ankle depends on where the injury is and how wrong the leg is.

If the child has twisted his foot

If the child has twisted the foot it may have a bandage, elastic bandage, as long as it hurts, which usually takes a week. During this time, the child usually avoids supporting the injured ankle, but if it does, it is good to strain. It is good to touch the ankle to get blood circulation started and to improve mobility. If the child does not want to support the foot, crutches can be good, but they can be difficult to use, especially for smaller children.

Sometimes the baby has to be anesthetized

If the leg needs to be corrected, the child must be anesthetized after anesthesia for long enough so that it does not risk vomiting during the anesthesia. That is why you should not give the child something to eat before going to the hospital, except possibly pain-relieving drugs.

The doctor straightens his leg

When the child is asleep, the orthopedic straightens the broken leg. Sometimes one or more screws are inserted to stabilize the damage. The screws are removed after about six months. Even then the baby is anesthetized.

The operation ends with a plaster foot

When the doctor feels that the injury is in a good position and is stable, the foot is plastered, and then the child is driven in his bed to a so-called awakening ward. There the child is allowed to lie down until they wake up 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.

Depending on how old the child is and how the injury looks, plaster dressing is needed for between four and six weeks. During this time, the doctor decides whether or not to support the foot. When the plaster is removed it may take another week before the child dares to load the foot and it may take even longer before they go as usual.

During the course of treatment, additional X-rays are made to see if the foot heals properly.

Crutches can be borrowed from the health center

The child can usually get crutches at the health care center or emergency room you have turned to for the first time. When the child no longer needs to join the crutches, they should be handed in at the nearest health center.

Small children under the age of six are usually unable to use crutches, and it is better with a walker.

It can be hard to have plaster

Children may find it exciting to have plaster 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.

The dressing must be protected from water

Children who have plaster should not bathe. The shower goes well, but the plaster must be protected from water because it can be loosened up by water. Dressings in the form of a plastic plaster are not destroyed by water, but the hydrogen stays inside the plaster and this makes the skin not feel well. There is a risk of fungal infection.

In pharmacies there are special plastic covers that can be used when the child is showering. It is also possible to use a dense plastic bag.

If the plaster breaks

If the plaster breaks it can be repaired or it needs to be replaced. If there is a problem with the plaster, you should 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 foot, the plaster must be sawn with a special saw. It does not hurt, but can give a vibrating feeling and feel a little scary. The foot can feel unusually light after removing the plaster.

Once the child has had the plaster removed, the doctor examines if the ankle seems to have healed and if more visits are needed. The doctor may need to do a new x-ray examination after a week to see if the bone fracture is still in a good location.

Children usually do not suffer any future discomfort from a broken ankle. However, it can take several weeks for the foot to feel good and the child can take part in sports lessons again.

What happens in the body?

Both children and adults can injure the ankles in the event of an accident. But a growing child does not receive the same damage to the skeleton as an adult, who has a fully grown skeleton. For example, children have stronger and more durable ligaments than adults.

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 common bone 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 changes as it grows. Therefore, misalignments after bone fractures do not always have to be corrected or operated. In children, misalignments are corrected by themselves, while adults who have the same misalignments 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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