Treatment

Fractures heal at different rates depending upon the age of the child and the type of fracture. Young children may heal in as little as three weeks, although it may take six weeks for the same kind of fracture to heal in adolescents.

The bone begins to heal at the location of the fracture as the bones produce new cells and tiny blood vessels to rebuild the bone. These cells cover both ends of the broken part of the bone and eventually close up the break.

Setting the break When a child breaks a bone, the doctor will first "set" the bone; this is known as a closed reduction. During a reduction, the doctor manipulates the fracture or displaced ends of the bone into proper alignment and then holds the realigned bone in place with a cast or pins.

Cast After a bone has been set, the next step is usually putting on a cast to keep the bone in place for the one to three months it will take for the break to mend. Casts are made of bandages soaked in plaster of Paris or fiberglass material, which hardens to a tough shell. Plaster of Paris is easier to mold over difficult fractures, but it is heavier and less resistant to water. Synthetic material comes in many bright colors, is lighter and cooler, and is often used for less complicated fractures. Fiberglass casts with waterproof liners allow children to bathe and even swim during the healing process. The liner allows for evaporation of water and sweat, but it is fragile and must be protected to allow it to function properly. A doctor will determine if the fracture may be safely treated with a waterproof cast.

The problem with casts (especially plaster casts) are that they can be uncomfortable and itchy. A child suffering from itchy skin beneath a cast may find relief by having air blown into the cast with a hair dryer on a cool setting. Baby powder or oils should never be poured into a cast, nor should an itch be scratched with a pencil or hanger. These remedies could irritate a child's skin and cause an infection.

Traction Certain fractures of larger long bones such as the thigh bone are hard to keep straight in a cast. Instead, some of these fractures are kept in traction for a few days until the fracture begins to show early healing; at this point, a cast can be applied to hold the bone straight until healing is complete. With breaks in larger bones, or more than two pieces, the doctor may put a metal pin in the bone to help set it.

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