BROKEN BONES

• Broken bones are fractured, and fractured bones are broken. Both terms mean the same thing.
  
  
• Sometimes treating fractured bones is simple – they may just require a cast. Other fractured bones, though, may need to be set. Yet others may require being supported by pins, rods, or plates and screws to keep the bones in place while they heal in addition to a cast.
  

Broken Bones: Wrist Injuries

• One example of a fracture needing only manipulation and a cast is the displaced distal radius fracture, part of the wrist. This is a common pediatric wrist fracture sustained by falling onto the hand. This teenager's wrist was anesthetized and moved back into place in Peds Ortho's office procedure room, and then placed in a cast. After 6 weeks, it healed without any problems.

• Some fractures require surgery by a pediatric orthopedic surgeon.
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
• An example is a common elbow fracture in small children sustained by falling onto an outstretched arm.
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  

• This type of injury can be treated with minimally invasive surgery. Pins through the skin stabilize the fracture after setting the bones.

• The femur, or thigh bone, is the longest and strongest bone in the body. Treatment of femur fractures, in part, depends on the age.
  
  
• This example shows x-rays from a 2 ½ year old who sustained a femur fracture from a twisting mechanism. This injury can heal quickly in a half body cast.
  
  
• Extensive improvement is often seen even after two months.
  
  

• In slightly older children (average 5-10 years of age), the same femur fracture can be stabilized by placing flexible intramedullary nails through the hollow part of bones, a minimally invasive procedure. No cast is needed.
  

• In children over the age of 8, and of adequate size, a more rigid intramedullary locked femoral nail can be used. Not only is a cast unnecessary, but often the fracture is sufficiently stabilized to allow partial weight bearing even as the injury is healing.