BONE, JOINT AND MUSCLE INJURIES
Injuries To Bone
Fractures in children are not uncommon and usually not serious. For instance, when children learn to walk, they
fall frequently and can get the so-called ‘toddler
fractures’. The child avoids putting weight on that leg and tends to
limp. These fractures usually heal without any treatment. But
if the symptoms persist for more than a day or two, you must see your doctor. Fortunately, most get better by restricting
the movement of the part and surgery is rarely needed.
After an injury, the bone may not fracture right
through. It may just bend and a crack may be noticed only on one side of
the bone. If the bone breaks through the skin and comes
out of the surface, it is termed an open fracture and needs
much more careful handling.
Fractures affecting the growth plate at the end of the
bones also need specialised treatment. Otherwise, the normal growth of that particular bone is affected.
MANAGEMENT: If you suspect a fracture (pain, local swelling and lack of movement of the affected limb),
make a splint from a piece of wood or folded newspaper. Put it
under the injured site to prevent movement. Use cold compresses on the site till your doctor sees the child.
If there is a possibility of a fracture affecting the
spine or neck, do not move the child yourself. Let the doctor
handle the case. If there is bleeding, apply firm pressure on
the wound (see Cuts).
The doctor may ask for an X-ray and decide to set the
bone by manipulation (closed reduction) or by an operation (open reduction).
Your child is walking by your side with your hand
holding his. He suddenly decides to move away from you. You pull him forcefully towards you. He complains of pain near his
elbow, which is slightly bent. Straightening the elbow causes
more pain. This is the description of a pulled elbow. These
children have a rather loose elbow joint. When you pulled him,
the upper end of the bone nearer the arm was pulled towards
you, creating a space between this bone and the other bones.
The tissue nearby slid into this newly created space. When
the pull is released, the bone goes back to its earlier
position, the tissue gets trapped inside the joint and the child feels
TREATMENT: A doctor in a hospital’s casualty department can easily set it right to bring immediate
relief from pain.
Sprains Affecting A Joint
The common example is a twisted ankle joint. The
ligament holding the joints together is either stretched
excessively or gets torn. Your child feels pain, refuses to walk and
you notice swelling around the particular joint.
TREATMENT: As there could be an underlying fracture, a medical opinion is desirable. Keep the joint motionless
while waiting for your doctor. If you have an elastic bandage,
wrap it around the joint, but not too tight. Remove it for a while every
2 hours to make sure that blood flow is not obstructed.
For pain, you can give the child paracetamol or ibuprofen. Keep the joint raised and give cold compresses with
crushed ice in a small hand towel or a piece of cloth. If you
are unable to consult a doctor, apply cold compresses for about 20 minutes, once every hour, for a day or two.
day or two, the swelling will become less or not increase any
further. Then give hot compresses every 2 or 3 hours.
In case the child cannot move his toes or the foot
appears limp, deep-seated serious injuries might have occurred. Urgent medical advice is needed.
Injury To The Tip Of The Finger Or Nail
This can be very painful and may even lead to a
permanent deformity of the growing nail. The tip of the finger can get caught in the closing door of the car or at home.
Sometimes, the injury is not severe and the child does not complain
of much pain. There is not much swelling as well. Such
cases can get better without any treatment. The problem arises
if you notice swelling or blood under the nail.
TREATMENT: Such a situation needs urgent medical attention. While waiting for your doctor, give cold
compresses with crushed ice in a small hand towel or a piece of
cloth. If ice is not available, take cold water and let the finger
be dipped in it. If the skin is cut, wash it with soap and
water and put sterile gauze (available in packets with your chemist) on it. If the finger is bleeding, a cold compress will
help. Too much pressure to stop the bleeding should be avoided, as there may also be an underlying fracture. Keep the
finger a little raised.
The doctor will decide if there is a need to remove
blood from under the nail by making a small hole in it. If he suspects a fracture, he will ask for an X-ray. Consulting an
orthopaedic surgeon is essential if a fracture is confirmed or if
there is damage to the nail bed, where nail growth takes place.
Injury To The Muscles
SYMPTOMS: Muscles are strained after sudden activity and exertion. Your child may complain of severe pain in one
or more muscles. He may not be able to move the affected
part, possibly because of bleeding within the muscle that makes it stiff.
TREATMENT: Raise that limb and gently massage it after applying hot compresses. In future, let him start an
exercise to which he is unaccustomed gradually and do warm-ups before any active sport.
11 February, 2013