Forearm Fractures In Children

What are Forearm Fractures In Children

A forearm fracture is a break in one or both of the bones that connect the elbow to the wrist, known as the radius and the ulna. The radius is located on the side of the forearm corresponding to the thumb, while the ulna is on the side associated with the pinky finger.

These fractures are particularly common during childhood, as they often result from falls that occur while the child is playing. They can happen at different locations along the forearm, including near the wrist, elbow joints, or in the middle of the bone.

Types of Forearm Fractures

Forearm fractures in children can be classified into several types, each with distinct characteristics.

Physeal Fracture

This type involves the growth plate or physis, particularly near the wrist. Physeal fractures are more common in younger children due to the vulnerability of the growth plates.

Torus Fracture

Also known as a buckle fracture, a torus fracture occurs when one side of the bone is compressed, causing it to buckle without breaking completely through.

Greenstick Fracture

In a greenstick fracture, one end of the bone breaks while the other end bends. It occurs because children’s bones are softer and more flexible.

Plastic Deformation Fracture

This type of fracture is characterised by the bending of the bones without an actual break.

Symptoms

The symptoms of forearm fractures in children can vary depending on the type and severity of the fracture.

• Swelling: This is often one of the first signs of a fracture, where the affected area becomes visibly swollen.
• Pain: Children usually experience pain, which may intensify when weight or pressure is applied to the forearm.
• Skin Bruising or Color Change: A change in skin colour or bruising is common in the area around the fracture.
• Crooked Appearance: The forearm may appear misshapen or crooked, indicating a possible fracture.
• Popping or Snapping Sound: Some fractures are accompanied by a distinct popping or snapping sound at the time of injury.
• Impaired Movement: Difficulty or inability to move the arm normally is an indicator of a fracture.

Causes and Risk Factors

Forearm fractures in children occur due to several factors:

• Falls
  The most frequent cause of forearm fractures is a fall onto an outstretched arm. This can occur during various activities, including playing, sports, or even everyday play.
• Direct Impact
  A direct blow to the forearm, either from an object or during a collision, can cause a fracture.
• Playground Injuries
  Playgrounds, with their heights and hard surfaces, are common sites for falls that lead to forearm fractures.
• Certain Conditions Impacting Bone Strength
  Children who have conditions impacting bone strength, including osteogenesis imperfecta, are at a heightened risk of fractures.
  
• Dietary Deficiencies Affecting Bone Health
  Adequate calcium and vitamin D intake is necessary for bone health. Deficiencies in these nutrients can weaken bones, making them more prone to fractures.

Non-Surgical Treatment Options

For many forearm fractures in children, non-surgical treatment is effective. They aim to ensure proper healing of the bone while minimising discomfort and disruption to the child’s life.

• Casting or Splinting
  Most forearm fractures can be managed with a cast or splint. This immobilises the bones, allowing them to heal in the correct position. The type of cast or splint and the duration of its use depend on the fracture’s nature.
• Closed Reduction
  In cases where the bones are misaligned, a procedure called closed reduction may be necessary. This involves manually repositioning the bones without surgical intervention. After the bones are realigned, a cast or splint is applied to keep them in place during the healing process.

Surgical Treatment Options

Surgical intervention may be considered in cases of open fractures, unstable or displaced fractures, or fractures that cannot be treated with closed reduction.

Open Reduction and Internal Fixation (ORIF)

During this procedure, the broken bone fragments are repositioned and secured with pins, plates, or screws. This ensures that the bones heal in the correct alignment.

Prevention Strategies

A combination of awareness, safety measures, and promoting bone health can help reduce the risk of forearm fractures in children.

• Safe Play Environments: Ensuring that play areas are safe, with impact-absorbing surfaces, can reduce the risk of fractures from falls.
• Active Supervision During Playtime: Active supervision during playtime, particularly in environments where children are prone to falls, can help prevent accidents.
• Use of Protective Gear to Prevent Injury: Protective gear, like wrist guards and elbow pads, may offer some safety benefits during sports and recreational activities.
• Bone-Strengthening Activities: Engaging children in weight-bearing exercises, including jumping rope, jogging, and walking, may contribute to the development and maintenance of strong bones.
• Ensuring Adequate Nutrition for Bone Health: Ensure a diet rich in calcium and vitamin D for bone health. These nutrients can help develop strong bones that are less susceptible to fractures.