Paediatric Injuries

The information here will help you understand your child’s injury, guide you through their rehabilitation and explain what you can do to help maximise your recovery.

Coronavirus / COVID-19 update

During the COVID-19 risk period, wherever possible we’ll be reducing face-to-face appointments and helping you manage your child’s injury remotely. This means that, in accordance with the British Orthopaedic Association guidelines, your child’s individual treatment and follow up plan may be different to what happens under normal conditions. An orthopaedic consultant or a member of the orthopaedic team will always review your child’s notes and x-ray and decide if a face-to-face follow up is necessary.

If we haven’t asked to see your child for a follow up, but you still feel you’d like them to see someone, you can book an open appointment at any time in the 6 months after their injury. Please call 01736 758892 to make an appointment.

Advice for a recent paediatric injury
In the first 72 hours, it’s important for your child to:

  • rest your injury
  • apply a cold pack regularly
  • elevate their injury where necessary
  • use a sling if they’ve been given one
It’s helpful to remember PRICE:

  • Protect
  • Rest
  • Ice
  • Compression
  • Elevate

Medication

Give your child their usual painkillers if needed, for example over-the-counter paracetamol or ibuprofen appropriate for their age.

Cold packs

Ice is a great natural anaesthetic that helps relieve pain and controls swelling. Apply ice packs or a bag of frozen peas wrapped in a wet thin towel to your child’s injury for up to 15 minutes every few hours.

Do not place ice in direct contact with the skin.

Sports

Certain injuries may carry an increased risk of further injury up to 12 weeks.

We recommend that your child avoids physical education (PE) until at least 6 weeks after their injury.

Check the rehabilitation plan for your child’s injury for specific advice.

Care plans for your child’s injury
Click on the box with your child’s injury to find information that will help you understand the injury, guide you through their rehabilitation and explain what you can do to help maximise their recovery.

Your child’s diagnosis should have been made by an orthopaedic consultant or one of the team working under the supervision of the consultant team. The information in these care plans is to help you understand the diagnosis and is not exhaustive. Their consultant may give you a different, personalised care plan based on your child’s injury and whether they need imaging (x-ray, CT scan, MRI or an ultrasound) or an operation.

Buckle/torus fracture

What is a buckle/torus fracture?

Your child has fractured their wrist. This is known as a buckle or a torus fracture. In this type of fracture, the bone bends instead of breaks.

It’s a common injury for children because their bones are softer and more flexible.

A buckle fracture is unlikely to move.

Healing

It normally takes 4 weeks to heal. Your child’s wrist may ache for a few weeks after this.

Follow up

Most injuries like this heal well with time.

We may need to follow up with your child. An orthopaedic surgeon and a trained nurse or physiotherapist will review your child’s notes and x-rays. They do not need to come to the Fracture Clinic for this. You’ll then get a letter confirming that the consultant is happy with the treatment plan. We may give you further advice where needed.

If after 6 weeks your child still has pain or swelling or feels they still have to use the splint, please call 01736 758892 to make an appointment.

Please call the Fracture Clinic on 01872 253091 if:

  • you have any questions
  • your child struggles with their splint or soft cast
  • your child has pain in an area other than their wrist.

If you or your child have a disability and you need a different method of support from us, please call us on 01872 253091.

Your child’s soft cast or splint

Your child may have been given a splint or soft cast in the Emergency Department (ED) or Minor Injuries Unit (MIU).

A splint is easy to apply and can be taken off easily at home once treatment finishes. Most children manage with a splint with no need for a plaster cast.

Your child will not need a splint to stop the fracture moving but it can provide pain relief.

Caring for your child’s soft cast

If your child has been given a soft cast, please see our plaster care guide on what to do if it’s uncomfortable or becomes damaged, and how to remove your child’s cast when we tell you to do so.

Caring for your child’s splint

If the splint gets wet you can remove and dry it. If the skin rubs beneath the splint or if you have any concerns, please contact us immediately.

When to remove the splint

We will tell you when to remove the splint. It’s usually around 4 weeks after the injury.

Movement

Your child can use their arm as long as they’re comfortable. They must avoid heavy lifting or loading.

Your child’s rehabilitation plan

Your child should:

  • attend school or nursery if they’re not in pain
  • keep the splint on at school for 4 weeks
  • avoid PE for 6 weeks after the injury
  • avoid heavy falls for 6 weeks
  • resume non contact sports such as swimming after the splint has been removed and as soon as they feel comfortable.

There’s a small increased risk of further injury for up to 12 weeks.

More information

For more information about buckle and torus fractures, please see this patient information leaflet (PDF, 101KB).

Clavicle fracture

What is a clavicle fracture?

Your child has fractured their collar bone (clavicle). The collar bone is the bone that runs horizontally between the top of your breastbone (sternum ) and shoulder blade (scapula).

Healing

It normally takes 4 to 6 weeks to heal. Younger children are likely to recover faster as fractures heal more quickly in this age group.

As the bone heals, you may notice or feel a smooth lump over the collarbone. This is a normal part of the healing process and the lump may flatten or reshape over time. It may persist but will not need further treatment.

Follow up

Most injuries like this heal well with time.

We may need to follow up with your child. An orthopaedic surgeon and a trained nurse or physiotherapist will review your child’s notes and x-rays in the virtual fracture clinic. They do not need to come to the Fracture Clinic for this.

You’ll then get a letter confirming that the consultant is happy with the treatment plan. We may give you further advice where needed.

If after 6 weeks your child still has pain or swelling, please call 01736 758892 to make an appointment.

Please call the Fracture Clinic on 01872 253091 if:

  • you have any questions
  • your child struggles with their sling
  • your child has pain in an area other than their clavicle
  • your child has severe pain which does not respond to painkillers
  • the pain persists or worsens after 3 weeks.

If you or your child have a disability and you need a different method of support from us, please call us on 01872 253091

Your child’s sling

Your child will have been given a sling by the Emergency Department (ED) or Minor Injuries Unit (MIU).

You can see more about how to fit your child’s sling, washing, dressing, and sitting with their sling in these videos.

If they’re struggling with their sling, please call the Fracture Clinic on 01872 253091 and we’ll be happy to give you advice.

Movement

Your child can use their arm as outlined in their rehabilitation plan below.

It’s important to keep their shoulder moving to prevent stiffness but not to aggravate it.

Your child’s rehabilitation plan

For the first 3 weeks after their injury, your child should:

  • wear the sling during the day except for exercises and washing
  • take the sling off at night
  • start taking the sling off for short periods of time
  • use their arm as comfort allows
  • avoid rough play
  • avoid PE
  • expect initial movements above shoulder height to be painful

Between 3 and 6 weeks, your child should:

  • start normal light activities including movements above shoulder height
  • remove the sling
  • still avoid PE

After 6 to 8 weeks, your child can:

  • resume normal activities as comfort allows
  • expect full shoulder movement
  • return to PE
  • have a mostly healed injury.

More information

For more information about buckle and torus fractures, please see this patient information leaflet (PDF, 72.3KB).