Sprains, Strains and Broken Bones

With nice weather fast approaching, your kiddos will likely be spending more time outside. Organized sporting events or simple backyard play can increase the risk for bone and joint injuries. Parents are often confused as to what injuries need to go to the emergency room right away and which can wait for the pediatrician or orthopaedist during regular office hours. Dr. Derek Kelly, an orthopaedic surgeon with Campbell Clinic and Le Bonheur Children's Hospital, gives expert insight into children's bone injuries.

WHAT TO DO
? Keep them still and help them support the injured area. Most kids will instinctively hold their arm or leg in the safest and most comfortable position after an injury.
? Make sure they are breathing normally (crying is a good sign that they are getting plenty of oxygen).
? Try to calm his or her fears.
? Check to see if the injured area looks normal. Severe fractures (those that need to go to the emergency room) often look strange. The arm or leg may be bent or badly swollen.
? Check to see if there is any bleeding near the injured area. Bleeding could indicate that the bone is broken and has come through the skin. This requires an immediate trip to the emergency room.
? Check to see if the fingers and toes are pink. This means that there is good blood flow and the injury has not damaged any blood vessels. If the fingers and toes are not pink a trip to the emergency room is required.
? Finally, if the injured area looks normal, there is no bleeding and if the fingers and toes are pink, then you would need to ask your child to gently move the joints (elbow, wrist, ankle) near the injured area. This might be a bit painful in a sprain or strain. But if the child isn't able to move the joints due to pain, it could be a badly broken bone and you need to go to the emergency room.

If everything appears normal according to the checklist above, it is probably safe to wait and make an appointment with your child's pediatrician or orthopedic surgeon during regular office hours. If you feel you need to go the emergency room, then it is important to support the arm or leg with a large pillow, stack of towels or rolled up newspapers. This will provide some comfort and support while on the way to the emergency room.

WHAT NOT TO DO
? Don't apply a tight wrap or constricting bandage. Broken bones cause swelling that could be made worse by tight bandages.
? Don't try to set or realign the arm or leg. Doing so could cause further damage and pain.
? Don't give your child anything to eat or drink before a nurse or doctor in the emergency room has seen the injury. Feeding your child or allowing them to drink could delay the use of certain medications to help control the pain and repair the broken bone.