Frequent fractures in children. Fractures of the bones of the legs in a child: features and signs, causes of frequent injuries, prevention and treatment. Treatment of bone fracture in children

A broken bone in a child can be caused by trauma, a fall, a blow. Children are more active outdoors and at home. Because of this, frequent falls, blows are possible, as a result of which bone damage occurs. But babies 1-2 years old are less prone to fractures than preschoolers. This is due to the elasticity of the bones, which have not yet fully strengthened in babies. Another reason why a child’s skeletal system can be damaged is serious injuries: a car accident, a fall from a height. With increased fragility of children's bones, damage occurs with a minor injury.

Symptoms

• Severe pain is usually felt at the site of injury.
• A few hours after the injury, swelling appears on the damaged area of ​​the body, and the pain begins to be aching in nature and spreads much further than the injury site.
• Gradually, the skin at the site of injury may become pale, and traces of damage are not excluded.
• In severe cases, there may be loss of pulse, tingling, numbness, and paralysis at or below the injury site.
• With a closed fracture, there will be no traces of damage on the surface of the skin.
• You can recognize an open fracture by the presence of bleeding and the appearance of a wound.
• If the first signs of a fracture are observed in different parts of the body, this may indicate multiple fractures.
• Multiple bone fractures in a child can be open and closed type simultaneously with the presence of appropriate signs.

Diagnosis of a bone fracture in a child

It is possible to determine the presence of a bone fracture in a child after the initial examination and complaints of the victim in the emergency room or the emergency department of the children's hospital. But in order to accurately diagnose bone damage, the doctor sends the baby for an x-ray examination. The damaged area is examined in two projections in order to most accurately determine the diagnosis and the location of the injury. Sometimes an MRI, CT scan, and other diagnostic procedures may be ordered. It happens that an X-ray examination of children does not show the presence of a fracture. In this case, the procedure is repeated after 1-2 weeks. If an incomplete fracture or crack is suspected, a test using a tuning fork is prescribed. In severe cases, to determine the state of internal systems and organs, an examination of the entire body of the child is carried out using tests and other procedures.

Complications

Usually closed fractures heal in 1-2 months without causing complications. But in some cases, a fracture can be dangerous. With an open fracture, there may be poor circulation, blood loss, or blood poisoning through the open wound. With a fracture of the spine, a child may develop osteochondrosis in the future. In some cases, fractures cause deformation of the spine and the manifestation of persistent pain. With a fracture of the pelvis, a violation of the organs of the genitourinary system is possible.

Treatment

What can you do

If a fracture is suspected in a child, parents should give him first aid. You can not panic and you need to calm the baby. Before providing first aid, you must call the hospital and call an ambulance. In case of simple fractures, if possible, you can independently deliver the child to the nearest hospital. It is necessary, with the help of improvised means in the form of a board, sticks and other objects, to immobilize a broken bone and fix it with a scarf, bandage or scarf. It is necessary to fix in a fixed position not only a bone with a fracture, but also neighboring joints. If the pain is severe, the child can take painkillers. With an open fracture, as a rule, tissue and skin damage occurs. Because of this, bleeding may begin, which should be stopped as soon as possible. If there are means for disinfecting the wound, it is necessary to disinfect it and apply a sterile bandage.

After the doctor conducts an examination and establishes the type and severity of the fracture, proper care of the affected child is necessary. Parents should provide the baby with a rational and nutritious diet, as well as take care of the use of vitamin complexes.

What does a doctor do

For children under the age of 7 years, the main method of treating bone injuries without displacement is the application of a plaster splint on a part of the limb for up to 3-4 weeks. In simple cases of damage to children's bones, there is no need to be in the hospital. Usually treatment and recovery is carried out at home. The child should visit the doctor once a week. If the child is diagnosed with a displaced fracture or severe comminuted bone damage, surgery is necessary using general anesthesia. After the necessary joints of the bones, a plaster splint is applied, and the baby remains for several days in the hospital. In some cases, fixation using metal wires or skeletal traction is used. After removing the plaster splint, a sick child can undergo a rehabilitation course of physiotherapy, massage, and physiotherapy exercises.

Prevention

It is necessary to explain to children the rules of safe behavior on the street, at home in children's institutions, transport. Young children need supervision. In the room where the child is located, there should be no dangerous objects that provoke injury. In the car, small children must be transported using a special fixing device. Parents should feed the baby foods rich in calcium and phosphorus, as well as foods high in vitamins and minerals.

Fractures of bones in children happen not only because of pampering, sometimes the fragility of the bone tissue is to blame for this. Why does it occur, how to detect and treat it?

Our expert is pediatrician Anna Mikhailova.

Risk factors

Experts call this condition osteopenia, which means that the bone mineral density is below normal. According to various studies, violations of this kind are found in every third teenager aged 11–17 years.

There are four main risk factors:

Deficiency of calcium, the main "building material" for bone tissue.

Wrong nutrition. In addition to calcium, bones need protein, phosphorus, iron, copper, zinc and manganese, vitamins (from autumn to summer it is necessary to take vitamin-mineral complexes). And all these useful substances, as a rule, are present in those products that children like the least.

Hypodynamia - for the growth of bone mass, movement is necessary that loads and trains the bones.

"Hormonal storm": calcium metabolism in the body is under the strict control of the hormonal system, and during puberty, disturbances in its work are not uncommon.

Many chronic diseases also “interfere” with the normal absorption of calcium: the gastrointestinal tract, respiratory tract, liver, kidneys, thyroid gland ...

Cunning of the Invisible

Loss of bone density develops slowly and gradually, it is impossible to notice it by eye. But there are five indirect signs that should alert parents.

The child has caries.

“For some reason” hair splits, nails exfoliate and break.

From time to time there are pains in the legs, especially in the legs.

The student stoops more and more, his back gets tired after a long sitting at the lessons or the computer.

Your child is allergic, because of this he has dietary restrictions, he does not eat dairy products and fish.

Even one such symptom is a signal that the child needs to be examined and find out if he really lacks calcium.

Norm and deviations

First of all, the pediatrician will prescribe biochemical blood and urine tests, which can be used to understand whether phosphorus-calcium metabolism is disturbed. These partner minerals are involved in many vital metabolic processes and work hand in hand: the body cannot absorb calcium if there is not enough phosphorus, but if there is an excess of the latter, calcium is excreted from the body. That is why it is so important to keep them in balance. Comparing the data with the norms of indicators for a certain age and finding deviations, one can suspect the initial stage of osteopenia.

To clarify the diagnosis, densitometry is performed: assessment of bone tissue (often using the ultrasound method). Unlike adults, children analyze only the so-called Z-criterion - that is, deviations from the norm in indicators depending on the age and gender of the young patient, which are calculated using a special computer program.

Will we fix everything?

The process of healthy bone formation can be adjusted as the child grows. For treatment, drugs containing calcium are prescribed.

The choice is large: for example, for the sake of prevention and with a slight deviation from the norm, calcium preparations with vitamin D are prescribed. If a deficiency of not only calcium, but also some trace elements is detected, complex preparations are used (they also include manganese, boron, copper, zinc, magnesium ).

Since some chronic diseases affect the absorption of calcium, children who have them are selected with special drugs, for example, for gastritis with high acidity, those that “protect” the process of its absorption from the aggression of gastric juice. The course of continuation of treatment is individual.

But drugs alone are not enough. Diet should reinforce the treatment: cottage cheese, cheese, kefir or yogurt, fish (salmon, sardines), meat, eggs, broccoli, bananas, legume dishes are recommended.

And of course, you need to make time for sports: at least for regular visits to the pool or fitness room. It is regular, and not from case to case. And if the child has posture disorders, flat feet, it is necessary to undergo treatment under the supervision of a pediatric orthopedic surgeon.

Typical fractures

Bone fractures in children - diagnosis

metaphysis of tubular bone

General principles of treatment

See also Fracture

ICD

Slepenko S.M. one

Kokhanovskaya M.A. one

1 Municipal budgetary educational institution of the city of Tulun "Secondary school No. 19"

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AT conducting

Nowadays, young children and teenagers often break the bones of their arms and legs. This school year in our class, three students, including me, broke their legs, and two more classmates were hospitalized with a dislocation and an incomplete fracture of their arms. I decided to find out why bone fractures occur and whether it can be prevented.

Selected research topic relevant, since in the last few decades in Russia 1 the frequency of limb fractures has increased, especially in children.

Purpose of the study: determination of the causes of fractures of the bones of the extremities and ways to prevent the occurrence of fractures.

Tasks:

to study theoretical material on the structure of bones, types of bone fractures, prevention of childhood injuries;

conduct a survey of students;

learn how to provide first aid for fractures of limbs;

prepare booklets for classmates on ways to prevent bone fractures.

Research methods: analysis of information, questioning, observation.

Research hypothesis lies in the assumption that fractures of the bones of the limbs occur due to non-compliance with safety rules.

Object of study: bone fractures.

Subject of study: causes of bone fractures.

Chapter 1. Theoretical foundations for the study of bone fractures

1. Interesting facts about the human skeleton

After studying the encyclopedia "Human Anatomy", we found out that the word "skeleton" in ancient Greek means "dried" - not a very suitable name for the engineering miracle created by nature, which supports you and gives your body shape. The skeleton consists of a large number of bones, they are interconnected and form a strong and light supporting frame. The bones are alive. They are formed by bone tissue - a type of connective tissue supplied with nerves and blood vessels. But the skeleton is not just a support system. Attached to bones are muscles that allow us to stand, walk, run, and jump.

The bones of the skull and ribs serve as protection for such fragile and delicate organs as the brain and heart. The skeletal system of the hands, which accounts for a quarter of all the bones of the body, allows you to write, sew, and perform other complex work.

We were greatly surprised to learn the fact that when a child is born, there are about 350 bones in his body, and the skeleton of an adult consists of 206 bones. So where do over 100 bones disappear to? The phenomenon of “disappearance” of bones from the body is explained by the fact that as the human skeleton grows and matures, it undergoes numerous changes, and many bones, especially small ones, grow together, forming larger formations. Skeletal growth stops at age 24.

So, we found out that in the body of an adult there are more than 200 bones of different sizes. So, the shortest bones are the three bones inside the ear. Of these, the smallest is called the stirrup (stirrup). Its length is slightly more than 3 mm.

The longest bone in the human body is the femur, which bears the weight of the entire body. It makes up ¼ of the total height of a person. This bone has a saber shape and normally withstands the mechanical impact of shocks, falls or compressions well, withstands a pressure load of up to 1500 kg. Damage to the hip bone is extremely dangerous and can lead to complete immobility in old age.

The most “bony” part of the body is the hands along with the wrists. It consists of 54 bones, thanks to which a person plays the piano, smartphone, writes.

Human bone is both light and strong at the same time. It is 6 times stronger than a steel bar of the same weight! But if, nevertheless, our skeleton consisted of steel bones, then the weight of the skeleton would reach 240 kg!

Bone is an organ that consists of several tissues (bone, cartilage and connective) and has its own vessels and nerves. Each bone has a specific, inherent only to it, structure, shape, position.

Bones are made up of organic and inorganic substances. Organic matter helps bones to be firm and elastic. Inorganic substances (phosphorus, magnesium, sodium, calcium) make the bone strong. The chemical composition of the bone is largely determined by the age of the person.

A healthy person must have strong bones. However, there are some factors that affect their strength, as a result of which a person can break his arms, legs, spine, etc.

1. Types of fractures

Fractures are bone injuries that break their integrity. Fractures can be classified according to several criteria. In modern classifications, the main types of fractures are distinguished:

1. due to occurrence:

traumatic - caused by external influences;

pathological - resulting from any disease;

2. according to the severity of the injury:

complete without displacement and with displacement of fragments;

incomplete, i.e. cracks and breaks;

3. according to the integrity of the skin:

closed fractures, in which the living tissue around the fracture site is not damaged;

open fractures of bones, accompanied by soft tissue injuries, as well as damage to human skin.

Lower extremity fractures include:

femur fractures

patella fractures

leg bone fractures

ankle fractures

foot fractures

Upper limb fractures include:

humerus

• elbow joint

  radius

  wrists

The fracture has signs in the presence of which it can be assumed that a fracture has occurred. It:

Pain- increases at the fracture site when pressed or loaded. For example, when tapping on the heel, the pain in case of a fracture of the lower leg will increase sharply.

Edema- occurs in the area of ​​​​damage.

Hematoma— i.e. a large bruise caused by damage to the vessels that carry blood in our body.

Absolute signs of a fracture:

unnatural position of the limb;

pathological mobility - the limb is mobile in the place where there is no joint;

crepitus (a kind of crunch) - felt under the arm at the fracture site, sometimes heard by the ear;

bone fragments - can be seen in the wound.

1. Causes of bone fractures in children

Vladimir Merkulov, professor, doctor of medical sciences, head of the N.N. Priorova in Moscow, says that the statistics of childhood injuries indicate that bone fractures in children occur most often with mild trauma and banal circumstances at home, on the street, on the sports ground, for example, when falling from a great height, while running or walking etc. Fractures of the bones of the hands in children are 2 times more common than those of the legs. The most common sites for fractures are the elbow and forearm bones. Fortunately, severe multiple injuries in children are not common, and account for 3% to 10% of all injuries of the musculoskeletal system. In a child, the bones are more elastic and less durable than in adults, so the risk of fractures in children is higher than in adults.

In addition to fractures that occurred due to negligence, carelessness, pampering, there are a number of reasons why they occur. It turns out that bone strength can decrease and doctors call this condition osteopenia. This means that the bone mineral density is below normal. According to various studies, violations of this kind are found in every third teenager from 11 to 17 years old. There are five main risk factors:

calcium deficiency, the main "building material" for bone tissue;

malnutrition- bones, in addition to calcium, need protein, phosphorus, iron, copper, zinc and manganese, vitamins, and all these useful substances are usually present in those foods that children love the least;

hypodynamia(sedentary lifestyle) - for the growth of bone mass, movement is necessary that loads and trains the bones;

"hormonal storm" - during the period of growing up, the child may experience disturbances in the body;

diseases gastrointestinal tract, respiratory tract, liver, kidneys, thyroid gland.

The loss of bone density develops gradually and it is impossible to notice it by eye, but here are 5 reasons why you can determine that there is not enough calcium in the body:

teeth began to deteriorate, that is, caries appeared;

“for some reason” hair splits, nails peel and break;

from time to time there are pains in the legs, especially in the legs;

in the classroom it is difficult to sit with a straight back, she gets tired very quickly;

if there is an allergy, because of which you need to limit yourself in nutrition and do not eat dairy products and fish.

Even if only one of these symptoms is present, it is imperative to go to the hospital, get tested and find out if there really is not enough calcium.

Strengthening bones contribute to a sufficient amount of vitamins and minerals in the diet. Mandatory for strong bones are calcium, magnesium, phosphorus, manganese, vitamin D, C, K and B vitamins. There are a huge number of foods rich in these trace elements and vitamins. These include: yogurt, cheese, salmon, spinach, soy, sardines, kale, cereals (such as brown rice).

Great damage to the bones bring:

• sweets,

  acidic foods and juices,

  alcohol.

Conclusions on chapter 1.

Bones are a unique building material. A healthy person must have strong bones. However, there are some factors that affect their strength, as a result of which a person can break his arms, legs, spine, etc. Fractures can be classified according to several criteria. The causes of fractures can be household injuries and serious malfunctions in the body. Strengthening bones contributes to proper nutrition, active lifestyle.

Chapter 2. Practical part

2.1. Research into the causes of bone fractures

Having studied the theoretical material, we decided to check the reasons for bone fractures in our classmates.

Purpose of the study: studying the causes of broken bones

Research method: a written survey of students who had a broken bone.

Data processing method

Attachment 1).

Bone fractures occur in children of all ages.

The schoolchildren called carelessness, inattention, falling from a bicycle, skating on the roadway the causes of fractures.

Students prefer a variety of foods, both healthy and unhealthy.

Most of the children, when asked if they go in for sports, answered yes, but they themselves write that in their free time they like to play on a tablet, computer, draw, watch TV.

All the guys who were treated after the fracture noted that they were scared before injections, they felt constant discomfort, their mood was often sad, sad.

The students advised all the children to be careful, follow safety precautions, and not to fall.

To find out food preferences, all students in the class were asked to fill out questionnaire No. 2.

Purpose of the study: Finding out the effectiveness of the diet of students in the class for strengthening bones.

Research method: a written survey of class students.

Data processing method: data analysis and generalization.

The results of the survey were summarized in visual diagrams ( application 2).

Analyzing the received answers, we made the following conclusions:

Eating fresh vegetables and fruits is not a constant in the diet of children.

Onions, garlic, parsley, dill are consumed only some of them daily in small quantities.

Dairy products are not consumed daily by the vast majority of the class.

Most of all, children prefer bakery products made from premium flour.

Fish dishes are rarely eaten.

Most of all, students like to drink sweet carbonated drinks.

Schoolchildren most often eat mashed potatoes as a side dish.

Sweets are a favorite treat.

Most of all, students love "harmful" (fried, fatty, smoked, pickled) food.

The results of the survey indicate that more than half of the students in the class are at risk. Such food preferences do not contribute to strengthening the bones and maintaining the health of schoolchildren. The survey data give grounds for the assumption that in addition to negligence, non-compliance with safety regulations, the causes of bone fractures can also be “weak” bones due to an improper diet and a sedentary lifestyle.

2.2. Child injury prevention

The problem of broken bones is serious. What can be done to avoid them? With this question, I turned to my grandmother Krivenko Tatyana Pavlovna, who works in the Tulun city hospital in the dressing trauma room. She advised me and my classmates:

adhere to proper nutrition, avoid "bad" foods (chips, soda, sweets, soda), try to eat more foods containing calcium, phosphorus (fish, dairy, meat products);

to be more often in the sun to get the body of vitamin D;

lead an active lifestyle, move more, play sports;

do not have bad habits;

maintain normal weight;

lift weights correctly

correctly allocate time for work and rest, do not strain the body.

follow the safety rules during sports, games, cycling.

2.3. First aid for fractures

It is very important to be able to give a person first aid. As it turned out during an oral survey of classmates, no one knew how to do this. This was taught to us by Elena Serebrennikova, Deputy Director for Life Safety, Information Environment of an educational organization.

Quite often, with a severe bruise, a bone fracture can occur. In these cases, first of all, complete rest is needed for the damaged area of ​​the body. For creating immobility (immobilization) in the area of ​​the fracture, the leg should be laid on a board, plywood or thick cardboard and bandaged to the leg. In case of a fracture of the bones of the hands, immobilization can be achieved by placing the arm, bent at the elbow joint, on a wide scarf, the ends of which are tied around the neck or the damaged limb is bandaged to the body. Due to immobilization, pain decreases, the patient's condition improves, and he must be urgently taken to the doctor, to the trauma department.

The rule that must be considered when immobilizing the damaged area:

it is necessary to fix the limb in the position in which it is after the injury and you should not try to set the bone in place, because. it can cause even more injury;

it is necessary to fix at least 2 joints (above and below the fracture). If there are wounds, you first need to treat the wounds, stop the bleeding, and only then apply splints.

Further treatment of fractures should occur under the supervision of doctors.

Conclusions on chapter 2.

During the research work, a large amount of literature was read and a lot of information was studied on the Internet.

We put forward a hypothesis that children can get bone fractures only because of their carelessness, non-compliance with safety rules. Our hypothesis was partially confirmed. In addition to non-compliance with safety regulations, there are other specific factors that affect the degree of bone strength: illnesses that a person has suffered, an insufficient amount of calcium and other minerals in the body, and a sedentary lifestyle.

Working on this topic, we realized that the causes of bone fractures can be both negligence and the internal state of the human body. Whether the “culprit” of fractures in our class is a lack of calcium or other minerals, we cannot say, since none of the students has yet passed an examination of the body to determine the amount of calcium.

Conclusion

The materials of our research were presented at the class hour. We think that classmates will have something to think about. The students were offered booklets containing information on the prevention of bone fractures. After all, each person can minimize the risk of fractures. And the most important thing in life is health!

We plan to acquaint parents with the research materials at the meeting. Perhaps this information will help parents adjust the diet of their children.

In the future, I would like to continue studying the issues of improving human health.

Bibliography

Andreeva T.M. Traumatism in the Russian Federation at the beginning of the new millennium / T.M. Andreeva, E.V. Ohryzko, I.A. Redko // Bulletin of traumatology and orthopedics named after N.N. Priorov. - 2007. - No. 2. - pp. 59-63

Richard Walker. Human anatomy. Illustrated atlas for children./ONYX 21st century. Moscow - 2001.

50 rules of healthy eating / Comp. G.S. Vydrevich. - M.: Eksmo; St. Petersburg: Tertsiya, 2007. - 64 p.

I know the world: Det.entsikl.: Medicine / Comp. N.Yu. Buyanova; Under total Ed. O.G. Hinn; Artistic A.V. Kardashuk, T.V. Berezkina and others - M .: LLC Firm AST Publishing House, 1999. - 480 p.

http://www.aif.ru/

Attachment 1

Questionnaire No. 1 results

7 students of the class who received a bone fracture in different years of life took part in the survey

Annex 2

The results of the answers to the questions of the questionnaire No. 2

18 students of grade 4a took part in the survey

1 Andreeva T.M. Traumatism in the Russian Federation at the beginning of the new millennium / T.M. Andreeva, E.V. Ohryzko, I.A. Redko // Bulletin of traumatology and orthopedics named after N.N. Priorov. - 2007. - No. 2. - S. 59-63.

The difference between childhood injuries and adults is explained by the peculiarity of the skeleton in a child. Mostly children injure their arms, legs, collarbone. Severe fractures, among all injuries in children, account for only 10% of cases. What is the danger of a fracture in a child, the symptoms and features of the recovery period, it is important for all parents to know.

More often the child injures the arms and collarbone, the legs break twice as rarely. Fractures of the feet, pelvis and other parts of the skeleton occur in only 1 in 1,000 children. This is due to the serious differences between the bone tissue of a child and an adult skeleton.

Among the reasons why the same damage in an adult and a child will have a different character are:

1. The bone tissue of the child is just being formed, so it is more porous;
2. There is more collagen in children's bones and the skeleton is more flexible; with age, the amount of this substance decreases significantly;
3. An increased number of haversian canals provides the child's bones with strength;
4. The periosteum of the bones of the child is thicker, many blood vessels pass through it. This tissue acts as a natural shock absorber and gives the skeleton flexibility. And in case of a fracture, due to the increased amount of nutrients, the callus forms faster;
5. The metaphyseal part of the skeleton and the epiphysis are separated by cartilaginous tissue, which softens any mechanical impact.

There is more cartilage tissue in the children's skeleton, since the bones did not have time to gain calcium. Due to this, children are less likely to get fractures, and in case of injury, fusion requires only 2-4 weeks.

Most fractures in children are of the "Green Branch" type. The bone breaks or bends. After a fracture in children under 10 years of age, pathologies can develop:

• Subsequently, the bone is bent;
• One limb becomes shorter than the other;
• Bone is not properly formed.

Pathologies after an injury appear in adolescence, when the bone tissue grows rapidly, and the body undergoes hormonal changes.

Classification of childhood bone injuries

Depending on the zone of damage to the bone tissue and the characteristics of the child's skeleton, fractures in a child are divided into several types.

With this type of injury, the apophysis, which is located under the joints, is damaged. The structure of the process is rough. Its main role is the fastening of muscles and ligaments of bone tissue. With a fracture of the epiphysiolysis, the damage occurs at the border of cartilage growth, and its atrophied part suffers.

The cells that form the bone are not damaged and blood circulation in the tissues is not disturbed. Disturbance in growth and bone formation from such a fracture occurs in one in a hundred cases. Among all fractures in children, damage to apophysiolysis accounts for 80% of cases.

Osteoepiphyseolysis and epiphysiolysis

These two types of injury are similar, differing only in the location on the arm or leg. The fracture occurs at the point of attachment of the cartilage to the ankle or to the wrist joint. A fracture in the elbow or ankle part is caused by a fall on an outstretched arm or on straight legs.

In osteoepiphysiolysis and epiphysiolysis, the distal parts of the bones shift and form an angle, the sides of which are open in the opposite part from the bend of the joint.

The soft upper structure of the bone is not as fragile and strong as in an adult, and when bent, an incomplete fracture is formed. The bone is covered with cracks, but remains in place and does not divide into several fragments. The injury is called a "green twig fracture". This variety occurs only in childhood.

The child does not lose the ability to move his arm or leg, swelling does not form on the soft tissues. Pain is the main symptom. The injury is often confused with soft tissue injury or joint dislocation.

All types of fractures in a child are divided depending on the nature of the origin of the injury and the condition of the tissues:

• Traumatic. There was some kind of influence on the bone from outside the body. Traumatic fractures can be accompanied by damage to nerve endings, muscles, tendons and blood vessels. According to the condition of the soft tissues above the fracture zone, traumatic injuries are divided into two types: open and closed. With a closed fracture, soft tissues are not injured, an open injury is accompanied by a rupture of the skin, blood vessels, and a wound is formed at the site of injury. With an open fracture, the child may die from blood loss;
• Spontaneous or occurring, due to a pathological phenomenon in the body. A fracture is formed due to a chronic disease associated with the destruction of bone tissue, under the influence of inflammatory processes or against the background of beriberi.

According to the location of bone fragments, fractures are divided into two types: with and without displacement.

All types of fractures with an unresolved upper part - the periosteum, belong to the subperiosteal group. Depending on the type of damaged bone, injuries are divided into three types: tubular, spongy and flat.

And also fractures are divided into groups according to the specifics of the line of damage:

• Longitudinal;
• t-shaped;
• Helical;
• Breaks;
• Vertical straight and oblique;
• In the form of the Latin letter V.

The simplest are considered vertical without debris and displacement. According to the complexity, all damages are divided into groups: multiple and isolated. With multiple trauma, several bones, soft tissues and blood vessels are damaged at once.

Symptoms of trauma at an early age

A complex injury with multiple fragments and displacement in a child and an adult has common symptoms:

1. The functionality of the limb is completely or partially lost;
2. Shock or stress, the child is accompanied by loud crying;
3. On the injured limb, swelling, redness is formed;
4. The limb is deformed;
5. The temperature rises to 37.8 degrees;
6. Hematomas form on the skin;
7. An open fracture is accompanied by bleeding;
8. The child is in severe pain. When you try to move the injured limb, the pain intensifies.

Symptoms can be pronounced or blurred, appear all together or one at a time. The symptoms of a “green twig” injury are minimized, but specialists can easily diagnose damage.

With pronounced symptoms, the child cannot move a limb and constantly cries. A subperiosteal fracture causes a blurred symptomatology:

• Slight redness in the area of ​​injury;
• Dull pain, which some children can easily bear;
• No deformation.

An undiagnosed “green twig” fracture in time can provoke the development of bone tissue pathology at an older age. A fracture is formed from any strong mechanical impact, since the bones of the child are more porous and there is not enough calcium in them.

Specificity in intact periosteal sheath that connects bone fragments, even after displacement. Such an injury grows together quickly, since an intact shell nourishes the tissues, and blood circulation in them is not disturbed. And if the displacement is not diagnosed in time, then the child develops a curvature of the bone.

Diagnosis of childhood injuries

A fracture in a young child is accompanied by loud crying; children over 4-5 years old can describe the pain, show the place of its localization. It is important for parents not to panic and not to scare the baby.

A splint is applied to the injured limb, the child is given an anesthetic: Ibuklin, Nurofen. A cold compress is applied to the injured area as a local anesthetic. A sick child should immediately consult a doctor.

If the fracture is open, and the child is bleeding, then first of all it is necessary to stop the bleeding and disinfect the wound. To do this, a compressive bandage is applied above the limb, damaged large vessels can be clamped with fingers. An ambulance is called.

Do not try to set protruding bone fragments on your own. This will make the doctor sterile instruments in the operating room. The protruding bone is covered with sterile gauze or a napkin before the arrival of doctors.

In the clinic, the child is sent for examinations:

• Visual examination by a pediatric traumatologist;
• X-ray in two projections.

During a visual examination, the doctor will try to determine the presence of a fracture by palpation, learn from the parents the mechanism of damage. An x-ray image will help to make a diagnosis and more clearly present the nature of the fracture line.

If the x-ray examination did not give results, then the child is assigned magnetic resonance imaging. The study will help to clearly identify damaged bones, blood vessels, nerve endings.

The injury could cause various pathologies in the child's body, and the child is additionally prescribed examinations by a cardiologist, a neurologist. Conducted electrocardiography, donated blood for antinuclear antibodies.

A greenstick fracture is only diagnosed with an x-ray.

Therapy for the little patient

Based on the diagnosis of the child and the general history, the doctor selects an individual treatment. Children's fracture is treated in two ways:

1. Conservative;
2. Surgical.

Conservative therapy

Conservative therapy - closed reposition of the bones, if the fracture is displaced, and the imposition of plaster. Non-surgical reduction is carried out in simple cases, and is carried out without anesthesia. Conservative therapy is suitable for a simple injury or a "green twig" type of fracture: foot, ankle, ankle, fingers, forearm.

To relieve pain, the child is prescribed analgesics. The pain symptom disappears on the second or third day after fixation. Anti-inflammatory drugs can help prevent complications.

And to speed up the fusion process, the child is prescribed vitamins with a high content of calcium.

Surgery for a child is prescribed in the most severe cases. Reposition of bone fragments by surgical intervention is divided into types:

• closed operation. It is mainly prescribed for intra-articular damage. The bones are fixed with metal needles that are inserted into the drilled holes. The ends of the spokes remain outside, and the fasteners are removed after the fusion of the bone tissue;
• open operation. It is prescribed in case of a fracture with multiple fragments and displacement in the area of ​​the epiphysis, inside the joints. Soft tissues are dissected, vessels are moved aside. The bone is fixed with metal plates. Soft tissues are sutured, the limb is fixed with plaster.

There is also external bone fixation, which is used if the soft tissues are damaged. This is due to a burn, damage to the vascular system.

All operations on the child are performed under gentle anesthesia. The plaster bandage lasts at least 1 month. Bone tissue recovery is monitored by x-rays, which are performed every 1.5 - 2 weeks.

The tissues in a child grow together quickly, this is due to the following factors:

• The child's body intensively produces collagen, which is necessary for the formation of callus;
• With a “green branch” fracture, blood circulation and nutrition of the bone tissue are preserved.

A fracture is dangerous in children aged 10–11 years. At this time, the bones grow intensively and a fracture can provoke different growth of fragments of one link. Differences in the size of the bones are prevented by a bayonet connection, which is performed by an open operation.

Any, the most insignificant children's fracture, needs treatment. Improper fusion entails recurrent fractures, and further development of bone tissue pathologies.

Recovery and rehabilitation

Fusion of children's bones requires less time than with an adult injury. If the arm is broken, the child will stay in a cast for no more than one and a half months, the legs will have to be kept in a bandage for up to two and a half months. The longest time will be required to restore the hip joint, the baby will have to lie in a special cast for up to three months.

The most difficult is considered a compression fracture. It will take up to 1 year for a child to recover from such an injury. The recovery time depends on the age of the baby and his individual health characteristics. Bones grow faster in children under 5 years old. The recovery stage is more difficult in children at the age of 10-11, when the bones grow intensively and a large amount of calcium is required.

Immediately after the plaster is removed, the child is prescribed the following procedures:

• Massage;
• Physiotherapy.

These procedures will help to quickly develop a damaged joint, normalize blood circulation and tone muscles. Spa treatment will help speed up rehabilitation.

Throughout the recovery period, foods rich in calcium and vitamin D3 are included in the child's diet: cottage cheese, lentils, corn, pomegranates, aspic, milk, fermented baked milk, kefir.

After a fracture, the child quickly recovers, the main thing is to surround him with attention and take care of the rest of the injured limb. Children quickly get used to the cast and stop noticing it by the end of the first week. And proper nutrition and vitamins will help the baby recover in the shortest possible time.