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LEG FRACTURE IN CHILDREN

(FIBULA FRACTURE)
Leg Fracture in Children

WHAT YOU NEED TO KNOW:

What is a leg fracture? A leg fracture is a break in any of the 3 long bones of your child's leg. The femur is the largest bone and goes from your child's hip to his knee. The fibula and tibia are the 2 bones in your child's lower leg that go from his knee to his ankle. Your child may have a Salter-Harris fracture, which is when a bone breaks through a growth plate.


What causes a leg fracture? The most common cause of leg fractures in children is trauma. This includes injuries caused by a fall, car accident, sports injury, and physical abuse. Leg fractures are commonly seen in small children learning to walk and are known as a toddler's fracture. This is a twisting injury that causes a fracture of the tibia and is due to a toddler's unsteady walk. Stress fractures are caused by doing frequent sports or physical training. Problems with bone formation, tumors, and bone diseases may weaken the bones and cause fractures.

What are the signs and symptoms of a leg fracture?

  • Pain that worsens when your child moves his leg

  • A lump, swelling, or bruise at the site of the fracture

  • Difficulty walking, lifting, or putting weight on the injured leg

  • Deformity (your child's leg is shaped differently than normal)

How is a leg fracture diagnosed? Your child's healthcare provider will examine your child's leg. He may touch areas of his leg to see if he has decreased feeling. He will check for any open breaks in the skin. He may check your child's ability to move his leg. Your child may need any of the following tests:

  • X-rays: This is a picture taken to check your child's leg for broken bones.

  • CT scan: This test is also called a CAT scan. An x-ray machine uses a computer to take pictures of your child's leg. The pictures may show broken bones or other leg injuries. Your child may be given dye before the pictures are taken to help healthcare providers see the pictures better. Tell the healthcare provider if he has ever had an allergic reaction to contrast dye.

  • MRI: This scan uses powerful magnets and a computer to take pictures of your child's leg. An MRI may show a fracture or other leg injuries. Your child may be given dye to help the pictures show up better. Tell the healthcare provider if your child has ever had an allergic reaction to contrast dye. Do not let your child enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if your child has any metal in or on his body.

  • A bone scan takes pictures of your child's bones. Your child may be given contrast liquid to help the pictures show up better. Tell a healthcare provider if your child has ever had an allergic reaction to contrast liquid.

How is a leg fracture treated? Treatment will depend on the kind of fracture your child has. Your child may need one or more of the following:

  • Cast or brace: This may be put on your child's leg to decrease movement and hold the broken bones in place. These devices may help decrease pain and prevent further bone damage.

  • Medicines:
    • Pain medicine: Your child may be given a prescription medicine to decrease pain.

    • Antibiotics: This medicine is given to help prevent or treat an infection caused by bacteria.

    • Tetanus shot: This is a shot of medicine to prevent him from getting tetanus. Your child may need this if he has a break in his skin from his injury. He should have a tetanus shot if he has not had one in the past 5 to 10 years.

  • Surgery: Surgery is often a treatment for leg fractures. Healthcare providers may make an incision on your child's leg and line up the broken pieces of bone. Wires, screws, or metal plates may be used to hold the fractured bones in place.

  • Traction: Your child may need traction when his bones are broken or out of place. Traction pulls on the bones to pull them back into place. A pin may be put in your child's bone or cast and hooked to ropes and a pulley. Weight is hung on the rope to help pull on the bones so they will heal correctly.

What are the risks of a leg fracture? If left untreated, your child may have increased pain and swelling. This may cause further injury to his leg. Your child may have bleeding or an infection, especially if his fracture was caused by trauma. His bones may not heal properly after surgery and his legs may not be the same length. Muscle weakness may happen after surgery. Your child is at risk of developing a fat emboli. This is when fat is forced out of the inside of the bone and travels to other parts of his body. It can block blood flow to his lungs, brain, or heart. This is a serious and life-threatening condition.

What can I do to help my child's leg fracture heal?

  • Rest: Your child should rest as much as possible and get plenty of sleep.

  • Ice: Ice helps decrease swelling and pain. Ice may also help prevent tissue damage. Use an ice pack or put crushed ice in a plastic bag. Cover it with a towel, and place it on your child's leg for 15 to 20 minutes every hour as directed.

  • Assistive devices: Your child may have to use crutches to help him walk. Crutches will also help your child take some weight off the injured leg while it heals.

  • Physical therapy: A physical therapist may assist your child with special exercises. This may help his leg recover faster and become stronger.

When should I contact my child's healthcare provider?

  • Your child has a fever.

  • Your child's cast or brace is too tight.

  • There are new blood stains or a bad smell coming from under the cast.

  • You have questions about your child's condition or care.

When should I seek immediate care or call 911?

  • Your child has increased pain in his injured leg that does not go away.

  • Your child's cast breaks or is damaged.

  • Your child's leg or toes are numb.

  • Your child's skin or toenails below the injured leg become swollen, cold, white, or blue.

  • Blood soaks through your child's bandage or cast.

  • Your child has chest pain or severe shortness of breath.

CARE AGREEMENT:

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.