Diagnose

Broken bones, or fractures commonly occur in childhood. It can be a normal part of play, sports or daily activities. We specialize in pediatric fracture care for infants, children, adolescents and young athletes. Our caring, highly trained team will help heal fractures—especially important with children and teens’ growing bones—and help you prevent further injury.

How to spot a fracture

If you think your child has a fracture, we're here to help. Our team treats more kids with broken bones than anyone in Georgia.*

A fracture is a break in the bone.

  • The fracture is called “displaced” if pieces of the bone bend or move out of proper position.
  • The fracture is called “non-displaced” if the bones stay in place.

Kids' bones are different

Our team knows that children and teens have different orthopaedic needs than adults. We address the following problems to help heal breaks and prevent future complications.

  1. Children’s bones are smaller than adults. Many of the orthopaedic devices and braces are designed for adults and don’t properly fit children. Our pediatric orthopaedic surgeons use unique techniques and implants to allow rapid healing with less immobilization time and fewer surgeries.
  2. Their bones are continually growing. This creates advantages and potential problems. During growth, the bone is likely to remodel and realign over time. This means if a bone heals crooked, it can straighten itself out over time. However, if the fracture occurs through the growth region (growth plate or physis), it can lead to significant deformity and impact the normal growth cycle.
  3. Children’s bones are more flexible than adults. While adult bones break, sometimes children’s bones bend. Ironically, sometimes bent bones can be more difficult to treat than broken bones.
  4. Children heal quicker than adults. Fortunately, our surgeons can often treat pediatric fractures with a cast and avoid surgery, as the bones heal rapidly and the body can naturally correct crooked bones.
  5. Children are often more active than adults. We create treatment plans with your child’s needs in mind. This often entails keeping a cast on until the fracture is completely healed to prevent further injury during activity.
  6. The ligaments are stronger than the bones. Therefore, fracture patterns are often different in children than in adults. Children rarely sprain their ankles; they break them. The most common fracture that doesn’t require surgery occurs in the forearm, and the most common pediatric fracture requiring surgery occurs just above the elbow.

Here are some common signs of a broken bone:

  • Pain
  • Swelling and/or deformity
  • Inability to move or put weight on the affected area

Your child may be able to use his hand, arm, foot or leg even though he or she has a fracture. This makes it hard to tell if your child has a muscle sprain or strain or a fracture. The only way to tell for sure is by having a medical exam and X-rays.

Our Urgent Care Centers and the emergency departments at our Scottish Rite and Egleston hospitals have fast access to pediatric orthopaedic surgeons who understand how to treat growing bones.

Locate a Children's Emergency Department near you

Locate a Children's Urgent Care Center near you

*Georgia Hospital Association (GHA) data 2016

How we diagnose a fracture

Not all breaks are easy to spot. Our board-certified pediatric radiologists are trained to quickly and accurately diagnose injured bones.

Our team uses X-rays to help diagnose broken bones. We follow Image Gently guidelines, which means we are able to reduce your child's exposure to radiation during X-ray procedures.

  • Children's bones are still growing, so there is more cartilage.
  • Because cartilage is not as dense as bone, it can make a child's X-ray look incomplete, like there are gaps in the bones and joints.
  • These gaps are where the growth plates are located, so it's important to have board-certified pediatric radiologists and pediatric orthopaedic surgeons who specialize in recognizing and treating broken bones in growing kids and teens.

Not every fracture shows up on X-ray, especially nondisplaced fractures. Children can have broken bones and yet have normal X-rays. It is hard to see a fracture if it occurs on the bone's growth plate. Since fractures can be hard to see at first, the doctor may tell you that your child's X-ray looks normal, but treat your child in case the fracture shows up on X-ray later. As a fracture heals, your child's body sends extra calcium, bone cells and blood vessels to rebuild the bone.

After seven to 10 days of rebuilding, there is enough calcium around the fracture so that it shows up on an X-ray. This is why one doctor may say that your child does not have a fracture, and then later, another doctor says your child does have one.

Learn more about our pediatric radiologists and guidelines

How fractures can affect your child's growth

Fractures to growth areas are quite common during childhood. In children and teens, bone growth happens at specific parts of the bone called growth plates. Growth plates determine the future length and shape of the bone. Since growth plates are made of cartilage, they are weaker than other areas of a growing skeleton. This makes them more vulnerable to injuries, including fractures. Pediatric orthopaedic specialists know how to properly diagnose and treat injuries to growth plates to minimize growth disturbances associated with a fracture. If an injury to a growth plate is not treated the right way, it could result in long-term complications like deformity or arthritis.

A fracture occurs when a force exceeds the bone’s ability to resist. The weakest part of a structure will fail first – often protecting surrounding bones. Cartilage is weaker than bone and in young children ligaments near a joint are stronger than the cartilaginous growth plate (physis). That’s why young children rarely sprain their ankles (a sprain is a ligament injury), but will break through the growth area of the bottom of the bone when they twist their ankles.

When the trauma is minor, permanent growth problems rarely happen. However, in major traumas, with more significant injuries, where the bones are crushed or the growth plate is compressed, a partial or complete growth arrest can occur, even if the fracture is perfectly fixed.

A partial growth arrest means that part of the area is growing but another part is not, resulting in a limb that grows crooked. A complete growth arrest means the limb will not grow at all, and will be shorter than the other side. It’s important to continue seeing your doctor until he or she has cleared your child after a fracture to the growth area, especially if around the hip, knee, or ankle. It may take up to one year to detect a problem, depending on the growth rate.

If a growth plate is damaged and not treated properly, it could:

  • Stop or slow a bone's growth
  • Change how a bone works
  • Cause the bone to grow crooked

Take Action

Steps to get help

If you suspect your child has a broken bone, it's important to get them care quickly so that their bones can heal properly.

1. Contact your pediatrician or visit a Children's Urgent Care Center or emergency department. If your child's bone is coming through the skin, call 911 or go to your nearest emergency department.

Find a pediatrician

Locate a Children's Emergency Department near you

You should consider taking your child to the emergency room if any of the following are true:

  • The skin is not intact (i.e. - the bone has pierced through the skin)
  • Your child feels numbness or tingling in the broken/injured area
  • You cannot control your child's pain

2. If your child is diagnosed with a broken bone, follow your doctor's orders. It’s important to seek early treatment for all fractures, as children’s bones heal quickly and may not be in the correct place. If you need to find a pediatric orthopaedic surgeon or pediatric hand surgeon to schedule an appointment, we have several on our team.* It is important to make an appointment approximately five to seven days after the injury. Bring any X-rays you may have on a CD to your appointment.

Find a pediatric orthopaedic surgeon

Find a pediatric orthopaedic hand surgeon (for hand or wrist injuries)

*Pediatric hand surgeons who perform services at Children’s Healthcare of Atlanta are independent providers and are not our employees.

3. If you have questions, call Fracture Care at 404-785-4913.

Our Orthopaedics Team

If your child doesn’t need immediate medical attention, but it is after hours or over a weekend, you can call Children’s Physician Group – Orthopaedics and leave a message. We are often able to accommodate your child for a same-day appointment at your preferred location.

Treat

Caring for broken bones

Your child's care team will create treatment plan designed for your child's needs. Treatment options depend on:

  • The type of fracture
  • Your child's age and health
  • Whether or not there are any other injuries

Your child's doctor will want to prevent the broken bone from moving so that it can heal. This will reduce damage to the tissue around the broken bone, including nearby blood vessels and nerves.

Ways to prevent the bone from moving might include:

  • Applying casts or splints.
  • Inserting hardware like screws, rods, plates or pins into the broken bone during surgery. If there is hardware outside the body, it will be removed when the bone heals.

Fractures can take from several weeks to several months to heal. The time it takes to heal depends on:

  • The type of fracture
  • Which bone is broken
  • How severe the injury is
  • The age of the child

Pain usually stops long before the fracture is healed. Your child will be able to begin some activity before the fracture heals completely. Even after removing the cast or splint, your child may need to limit activity until the bone is solid enough to use normally.

If you have concerns about your child, call his or her doctor.

Physical therapy

Depending on the type and severity of the fracture, your child's doctor may recommend physical therapy after the bone has healed to help regain strength and movement.

Locate a Children's outpatient physical therapy location near you

Locate a Children's sports medicine physical therapy location near you

Prevent

Here are a few tips to help prevent a fracture.

For babies and toddlers:

  • Always use a baby or child car seat each time your child rides in a vehicle.
  • Use baby gates at the top and bottom of stairs.
  • Do not use baby walkers.
  • Do not leave your child alone in a high place, such as a changing table, bed, sofa or chair— not even for a second. Use safety straps in high chairs and grocery carts.

For kids and teens:

  • Always use a booster seat or seat belts each time your child rides in a vehicle.
  • Use helmets, pads and safety gear when your child plays sports.
  • Make sure your child gets enough calcium and vitamin D to build strong bones. (Recommended daily dosage of vitamin D is 600 IU, and 1,000 – 1,300 milligrams of calcium.)
  • Have your child get plenty of exercise to help him stay strong and fit.