You know your toddler can be tough. Ever since she learned to walk, run and jump, that’s all she’s done. She attempts to fly off the couch, tries to scale the wall and has even rolled off the bed a time or two. The times she falls, she usually just cries for a few minutes and then is right back at it.
The reason she’s able to perform all of those daredevil moves without serious injuries is that her bones are pliable and have a thick covering. That means they’re flexible and strong enough to absorb quite a bit of shock.
But that’s not to say young bones can’t break. Fractures, also known as broken bones, are the fourth most common injury for kids under age 6, according to the American Academy of Pediatrics (AAP).[1]
The good news: Thanks to the flexibility of a youngster’s bones, they don’t break as easily as adult bones. Young children also heal much more quickly than grown-ups.
Should your little ball of activity end up on the unfortunate side of a jump, hop or skip, here’s what you should know.
How babies and toddlers fracture bones
Here are the most common causes of fractured bones in toddlers and babies:[2]
- Falls. Slips and falls are the most common reason a baby or toddler fractures a bone. As your child walks, runs, jumps and plays, she may topple and land the wrong way, causing a crack or break in a bone.
- Car accidents. Outside of playing, this is the other major cause of broken bones in young children and tend to lead to more serious fractures.
- Abuse. Unfortunately, physical abuse is another cause of broken bones in some children.
Types of bone fractures in toddlers and babies
The most common fractures in a child are the clavicle (collarbone) and the forearm.
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- A collarbone fracture sometimes occurs during childbirth, but can happen anytime a person falls onto the shoulder or an outstretched hand.[3]
- A forearm fracture can occur near the wrist, the middle of the forearm or near the elbow. That usually happens when a child falls onto her arm or there’s a direct blow to the forearm (like from a ball).[4]
It’s also possible for toddlers (and babies) to fracture bones in the fingers, elbows, shinbones, thighbones, ankles, toes and other areas of the body.
Because their bones are softer than adults, young children tend to suffer different kinds of breaks:[5]
- Greenstick fractures occur when the bone breaks only on one side, literally like a green twig on a tree.
- Buckle fractures (also called torus fractures) occur when the bone is buckled, twisted and weakened, but not completely fractured.
- Bend fractures are a common injury in which the bone is bent but not broken.
- Growth-plate fractures affect the special plates at the ends of bones that regulate growth. These breaks are considered more serious — if they don’t heal properly, future development could be affected. For this reason, tots are closely followed for up to 18 months after this kind of break. These fractures can be difficult to detect, so if your doctor suspects this, it will be treated anyway.
- Toddler’s fractures, also known as CAST (childhood accidental spiral tibial) fractures, occur when a child twists a foot during a trip, stumble or fall, causing the shinbone to break in a spiral-like pattern. These fractures can also be difficult to detect (there’s no separation in the bone), so if your doctor thinks it's this type of fracture, he or she will treat it as such.
- Complete fractures occur when the bone breaks all the way through.
What are signs of bone fractures in children?
Sometimes, it can be obvious that your toddler has fractured a bone. Other times, though, it can be difficult to determine, especially since kids this age may not be able to express what they’re feeling. Baby or toddler fracture symptoms may include:[6]
- A snap or grinding noise when the injury occurred
- Swelling and bruising
- Severe pain, particularly in one spot
- Tenderness to the touch
- Bent or deformed appearance of the limb
- Numbness
- An inability — or unwillingness — to move the limb (Important note: A child may still have a fracture even if she can move the area.)
- Child can't stop crying because she’s in so much pain
- Child is unable to stand or walk (for instance, in the case of a thighbone or ankle fracture)
- Bone sticking through the skin
What should I do if my toddler fractures or breaks a bone?
If you notice any of the above signs, call your pediatrician immediately. The doctor will either ask you to bring your child in or send you straight to the emergency room.
If your child has a broken leg, you suspect your little one’s head, neck or back may be injured, or the fracture is so severe that it’s punctured the skin and you see the bone poking out, don’t attempt to move her. Call 911 instead.[7]
In cases outside of those listed above, you’ll be instructed to head to the pediatrician’s office, urgent care or ER.
To help keep your tot’s limb steady until you get there, make a homemade splint to protect the injury from unnecessary movement.
- First, carefully cut any clothing away from the injured area with a pair of scissors.
- Next, being careful to keep the limb in the same position, wrap a towel (or dishcloth) around it.
- Then place something firm (rolled-up newspapers or magazines, or a ruler) next to the soft cloth.
- Fasten the splint securely with bandages, scarves or even neckties, but not too tightly because you don’t want to cut off your child’s circulation.
As difficult as it may be, don’t give the child any food, drinks or medication to relieve pain without first consulting the doctor. You can ice the fractured area with a cold pack wrapped in a towel or cloth to avoid direct contact with skin and exposure to extreme cold. Some younger toddlers or babies might resist but older tots may let you apply the ice pack to the wound.
How do doctors treat bone fractures in children?
Once you reach the ER or doctor’s office, the medical staff will ask questions about what happened as well as the last time your child ate or drank (in case she needs anesthesia).
The doctor will examine the injury, and if a fracture is suspected, your child will be sent to have an X-ray to confirm the type and location of the fracture. If necessary, she may be given medication to ease the pain.[8]
If the bone is broken, the doctor will probably call an orthopedist (a bone specialist) to put a cast on your child’s fracture. Or your child may be placed in a splint (similar to a cast but not hard all the way around) and referred to the orthopedist for a cast once the swelling has gone down, usually within a week.
If the specialist needs to manipulate your toddler’s arm or leg to set the bones back in place before casting them, your child will be sent to the ER and given an anesthetic through an IV. This anesthesia typically lasts only 20 minutes or so, just long enough to put the bones back in place and get the cast on.
If the injury is a simple break and the bones don’t need to be manipulated, your child’s arm or leg will just be put into a cast — no anesthesia necessary. Only rarely do broken bones in children require surgery before the doctor applies a cast. If it is a severe fracture or has associated complications, your little one need to be admitted to the hospital for surgery, observation and/or pain management.
The type of cast your kiddo will get depends on the location and type of fracture. Most fractures usually require a plaster or fiberglass cast, but for others, an immobilizing splint is all that’s needed. Some fractures, like those in the foot, may require a walking cast (a special cast boot).[9]
Once the cast or splint is on, you’ll probably be sent home with pain meds for your little one. You may have to follow up with the orthopedist and make regular appointments for your toddler until the bone has healed and the cast can be removed.[10]
How long does it take for a toddler’s bones to heal?
Fortunately, a young child’s bones heal much quicker than the bones of an adult. Toddler fracture healing time depends on what bone was broken and the type of fracture.
For example, a finger fracture usually requires only about three to four weeks to heal, the forearm takes three to six weeks (although it can also take up to 12 weeks), and healing time for the elbow or hand can be between three and six weeks.
On the lower end of the body, the toe or forefoot can take four to eight weeks to heal, an ankle can take between six and 12 weeks, and the time for a thighbone fracture to heal can be a few months.
The pediatrician or orthopedist will remove the cast once the bone has healed. Until then, follow the doctor’s instructions for caring for your child while in the cast, and do your best to keep your little one comfortable.[11]
What happens after my toddler’s cast is removed?
Once it’s time for the removal, the doctor will talk to you about what to expect after a cast is removed.
In general, you can expect your child’s skin to look pale, and it will feel dry and flaky once the cast is off. That’s normal and is due to the buildup of skin that usually gets washed off during the daily bath or shower (when the body part isn’t in a cast).
Use a washcloth, gentle loofah or a puff to get rid of the dead skin. Be patient and don’t scrub too hard. It may take a few baths or showers to remove it all, but the skin will look normal eventually.
Your child may also have some stiffness or soreness in the area that was in the cast, and the muscles will look smaller. This, too, is normal and will improve within a few weeks.
Depending on the fracture, your toddler may be required to do specific exercises that improve the motion of the joint, muscle strength and flexibility. The doctor may also say your child should avoid certain activities, such as playing on the playground.
How to prevent broken bones in children
Although broken bones in children are common, you can reduce the likelihood of it happening to your child again. These tips will help prevent any further broken bones (or help your baby or toddler remain fracture-free from the start).
- Let children run and jump but protect them. The sprinting (no matter how slow!), squatting, leaping and other movements stimulate bone growth and make bones stronger. But do try to remove obstacles ahead of time and be vigilant about stunts or climbing equipment that might be beyond your critter’s coordination level. And always leave your child with a patient, trustworthy caregiver to avoid neglect or abuse in your absence.[12]
- Make sure your little one gets enough calcium, vitamin D and vitamin C. Your child's body needs calcium (found in dairy foods, of course, and also in leafy greens and many other foods) to make healthy bones. And vitamin D is what helps the body absorb the calcium. Therefore, your tot needs plenty of both. Most children can get the recommended amount of calcium by eating two to three servings a day of dairy products. The AAP recommends all infants under 1 year of age have a minimum intake of 400 IU of vitamin D per day beginning soon after birth and 600 IU after age 1. If you’re nursing an infant exclusively, or giving a combination of formula and breast milk, ask your doctor about a vitamin D supplement. Vitamin C is also important for healthy bones and can be found in a variety of fruits, veggies and other foods.[13]
- Take time to childproof your home. Even though you did this before your baby was born, do another round to toddler-proof your house. Put gates at the top and bottom of stairs and secure heavy, climbable pieces of furniture, like bookcases, TVs and dressers, to the wall so they don’t topple over.
- Never use walkers. According to the AAP, baby walkers don’t help kids learn to walk. Worse, they cause thousands of injuries to children each year. Stationary activity centers (like ExerSaucers) are much safer.[14]
- Skip crib bumpers. Not only can they be a sleep safety risk, but as your baby grows, she might use them as a step to climb (and maybe fall) out of the crib.
- Always use a child car seat installed in the car properly, and keep your baby or toddler rear-facing until she reaches the highest height or weight limit as set forth by the manufacturer. Also make sure your little one is strapped in properly before driving.
There’s no doubt about it: Seeing your little munchkin injured is tough. And if your child does break a bone, you likely feel tons of guilt.
But try not to beat yourself up. These things happen sometimes. Fortunately, a toddler fracture heals up quite nicely and quickly. Within no time, your rambunctious go-getter will be zooming through the house looking for the next adventure.
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