The child suffered a broken leg - your actions

Localization of symptoms

To suspect a broken leg in a child, it is not necessary to see an open wound and bone fragments. Sometimes external signs cannot be determined by eye due to compression or incomplete fracture of the “green branch”. Any area of ​​the leg is susceptible to injury, the symptoms will vary:

• Sharp unbearable pain in the hip joint, shortening, pathological mobility of the limb, the leg is turned outward, bruises, swelling in the groin - these symptoms indicate a displaced femoral neck fracture. Cervical injuries without displacement have mild symptoms. The child can even walk.
• Knee pain, swelling, and swelling associated with bleeding into the joint characterize a fracture of the kneecap. The child cannot even bend his leg. If the fragments have separated by more than 0.5 cm, the supporting function suffers.
• Deformation, pathological mobility of the leg, severe pain, hematoma, swelling indicate a double fracture of the tibia and fibula. If only one bone was damaged, the child will still be able to lift the leg, and the deformation of the lower leg will be minimal.
• Severe pain in the leg, worsening if the child tries to move the leg, hemorrhage, swelling, partially impaired support function - symptoms of a fracture of the foot bones.
• The heel is turned outward, sharply thickened, the motor functions of the ankle joint are impaired - these are signs of a fracture of the heel bones.
• Pathological mobility, unnatural position of the toe, traces of a hematoma under the nail, on the skin, swelling, acute intense pain that intensifies when the baby tries to lean on the foot, indicate a fracture.

Signs of a metatarsal fracture

Fractures of the metatarsal bones occur in women, men, and children due to:

• injuries, accidents;
• falling, jumping from a height;
• hitting the metatarsus with a heavy object;
• strong constant load on the feet of athletes and people of heavy physical labor;
• diseases of the skeletal system.
  A fracture can be closed or open, with or without bone displacement. Characteristic signs of a metatarsal fracture:
• when you hit the foot, you hear the cracking of bones;
• sharp pain when trying to stand on your leg;
• the fracture area turns red and swells;
• With an open fracture, the bones protrude from the wound.
  When falling with a twisted leg, for example, from the step of a bus or a high staircase, an injury to the 5th metatarsal bone, which leads to the little toe, is noted. A fracture of the fifth bone at the base is called a Jones fracture. Orthopedic surgeon Robert Jones studied and described in detail injuries to the fifth metatarsal in 1902. Damage to the structure of the 1st and 2nd metatarsal bones is observed in athletes - speed skaters, hockey players, ballerinas.

  Symptoms of damage to the metatarsal bones require immediate medical attention. The assistance provided in the first hours will prevent complications and increase the effectiveness of treatment for a fracture of the metatarsal bones of the foot.

How to help a child?

The quality of treatment for any fracture depends on timely first aid. Therefore, while waiting for the ambulance to arrive or before independently transporting the victim to the emergency room, you must take the following actions:

Calm the child down and give him pain relief. Prolonged stress combined with painful shock has a bad effect on the nervous system and can even cause fainting.

Find the fixing material. Traumatologists use special Kramer and Dichters splints and plaster splints, but improvised means are also suitable. You can use any suitable object: board, umbrella, stick.

Ask your child to relax his leg as much as possible, place it in the most comfortable position, and wrap it in a soft cloth so as not to pinch the joints. Tie your leg to the splint with a bandage, pieces of fabric, or belts.

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If the child has an open fracture accompanied by heavy blood loss, apply a tourniquet to the palm above the wound. Sprinkle streptocide on the wound.

Remember: without medical skills, do not try to set broken bones yourself, as you may cause additional damage or cause infection.

Recovery

Complete healing of the bone tissue of the metatarsus will occur in a few months. The Jones fracture heals especially poorly, which is due to slow blood circulation in the 5th metatarsal area. The recovery period can last up to six months.

Early recovery period Until the plaster is removed, you cannot lean on your foot. You can bend and straighten your leg at the knee, lying on your back and alternately raising your legs to a small height.

Nutrition plays a big role in the healing of the metatarsal bones. The diet should include:

The human foot skeleton consists of 26 bones. Intra-articular fracture of the fifth metatarsal bone of the foot and other mobile joints of the leg has an ICD 10 code S92. Injury occurs due to the following unfavorable factors:

The main symptoms to suspect damage to the metatarsal bone of the foot are as follows:

• Crunching when the foot is injured.
• Pain that occurs immediately or after a short time, and gets worse when you try to step on your foot.
• Insufficient mobility of the foot.
• Decreased temperature and numbness in the leg.
• The foot takes on an unusual appearance.
• Noticeable shortening of the fingers, there are tubercles under the skin formed by displaced fragments, deviation of the metatarsal bone to the side.
• Swelling, which usually appears on the second day after injury.
• Bleeding - with an open fracture of the metatarsal bones.

Sometimes the symptoms can be “erased”; only a specialist can accurately determine whether there is damage, using special examination methods.

Treatment of femoral neck fracture

If the femoral neck is fractured, the child must be hospitalized in the traumatology department. If the fracture occurs without displacement, the leg fusion occurs in traction. An adhesive plaster and a small weight are used. The leg is retracted outward, then a splint is applied, in which the child will spend the next 2–2.5 months.

A displaced femoral neck fracture in a child requires treatment with skeletal traction, also with leg abduction. Epiphysiolysis of the femoral neck requires 2 months of traction. The transcervical and trochanteric fracture heals in 3–4 weeks with traction. Afterwards, a plaster cast will be applied to the entire hip area for 1.5 months.

Rehabilitation of the femoral neck begins from the first days of treatment. The child is forced to lie in traction for a very long time, so that bedsores do not form, he is prescribed a course of exercise therapy. Therapeutic exercise is the basis for restoring the functions of the femoral neck. The exercises are developed by the attending traumatologist, who will take into account the characteristics of the injury, the condition and age of the child.

Also, the femoral neck rehabilitation program includes a set of therapy that restores the anatomical structure of the joint and accelerates bone fusion in the form of UHF, massage and physiotherapy.

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Fractures of the leg bones in children

Tibia fractures in children are a common injury. Both isolated damage to the tibia and disruption of the integrity of both bones of the leg can be observed. Isolated injury to the fibula occurs extremely rarely.

The severity of the injury can vary significantly and depends on the level and type of fracture. In a normal fall on the street or while playing, fractures of the tibia in children are usually isolated. In case of road traffic injury and falls from a significant height, a combination with damage to other skeletal bones, head injury, spinal cord injury, blunt abdominal trauma, trauma to the pelvic organs and injuries to the chest is possible.

Fixation of the bone diaphysis

This is the most severe damage to the femur, according to statistics, accounting for 60% of all fractures. Usually the child is prescribed conservative treatment. One of the methods is used:

• The child lies in traction until the fracture heals completely;
• Traction is combined with immobilization. A plaster, plastic bandage is used. For about three weeks, the child lies in traction, when a callus forms, it is replaced with a plaster cast. The baby will stay in it until complete recovery;
• The victim is immobilized using a coxite bandage.

The traumatologist decides which method to use, taking into account the characteristics of the injuries. The first two dressing options are most often used. Plaster application without traction is allowed only for impacted and subperiosteal fractures. Patients under five years of age are recommended to undergo adhesive traction, and for older children - skeletal traction. Complete bone fusion occurs on average in 4–8 weeks.

Surgical intervention is prescribed to a child only if it is impossible to provide him with high-quality traction, if there was a comminuted fracture with subsequent tissue interposition. In such cases, hip osteosynthesis is performed.

The operation uses locking screws. Doctors try not to use metal structures; they cause active growth of periosteal tissue in children. The procedure takes place under anesthesia. Afterwards, the child will be put in a cast, in which he will stay for 6–8 weeks.

Complications after a fracture

Treatment and rehabilitation often determine the type of complication and how many there will be. Due to a fracture of the base of the foot, severe swelling in the lower leg area very often occurs in people over 45 years of age. There are also complications in the form of deformation of the foot and its bones. This very often leads to gait disturbances. In cases where the fracture affected the joint tissue, arthrosis sometimes occurs. When the foot does not heal properly, frequent pain in the area of ​​the recent fracture intensifies. In some cases, the function of the foot itself is greatly deteriorated. Complications after a fracture of the base of the foot are exactly the same. To avoid severe complications, after a fall you need to check the symptoms and immediately take them to the doctor! Remember that qualified medical care will help you much better than you can.

If treatment was carried out through surgery, then purulent inflammation or necrosis of some tissues may occur.

That is why recovery after a fracture is so important for the patient and how much effort he puts into this matter will determine his future health.

Treatment of a foot fracture

The foot consists of the tarsus, metatarsal bones and phalanges. Depending on the location of the injury, the following types of foot fractures are distinguished:

• Tarsal injury . When exposed to external forces, the heel bone is damaged, and less commonly, the talus bone. Other types of fractures practically never occur in children;
• Metatarsus injury . Fractures can be very severe, multiple, accompanied by displacement of fragments and damage to surrounding tissues;
• Finger injury . Injuries to the first and third fingers in children are common and may have signs of open and closed fractures.

Heel injury

A non-displaced heel fracture is treated in a trauma center. The doctor places a special splint on the foot, in which the arch of the foot is carefully modeled. After 3-4 days the bandage is circulated. Children aged 8–10 years spend about 3 weeks in a cast, older ones – 4–5. After removing the bandage, the patient uses orthopedic instep supports for 6 months.

If displacement of the fragments is detected, the child is hospitalized in the department. Here the traumatologist will perform immediate reduction under general anesthesia. After which a plaster cast will be applied to the entire leg, including the middle third of the thigh. The leg is in the optimal position - the knee is bent at a right angle, the foot is also bent. After 2 weeks of fusion, the plaster is removed, the foot is given a natural position, and the bandage is replaced with a special plaster boot. The heel will remain in a fixed position for about seven more weeks.

Metatarsus fracture

If the damage occurs without displacement, or the displacement is no more than ½ of the normal diameter, children are prescribed outpatient treatment. A splint is applied to the injured foot, and after a week the bandage is circulated. The length of time spent in a cast varies depending on age. Children under 10 years old wear the bandage for about 3 weeks. Older children – a week longer. You can lean on the sore leg only 10–12 days after the fracture.

The presence of greater or angular displacement of the metatarsal bones indicates the need for hospitalization. In the trauma department, reduction will be done under general anesthesia. Then a similar treatment is carried out - a week in a cast. Fusion takes place in 5–6 weeks, but from 15–18 days you can lean on your leg. After complete recovery, you should use an arch support for six months.

Surgery for this type of fracture is rarely performed. Only if there are open wounds, soft tissues are pinched by fragments, or bone fragments cannot be properly fixed. The operation is also performed under anesthesia, but implants are not used. The doctor stitches the fragments together or fixes them with a knitting needle.

Toe injury

A fracture of the toe does not require hospitalization of the child, so treatment will take place in a trauma center. If no displacement is detected, the foot is cast for 7–10 days.

Despite the good prognosis, traumatologists recommend not using an adhesive bandage. It compresses the small blood vessels of the finger, provokes swelling and is practically useless for an active child.

For displaced finger fractures, reduction is performed under local anesthesia. Fragments that cannot be securely fixed with plaster are fastened through the skin with a knitting needle or an injection needle.

To fix the fragments of the main phalanx of the finger, it is bent and until the knitting needle is removed, it remains in this position. Similar manipulations on the middle and nail phalanx are carried out in an extended position of the finger.

Next, a plaster cast is applied, the wire is covered with sterile material, and dressings are performed every 1–2 days. After 12–15 days, the child undergoes an X-ray control. If signs of a callus are visible, the needle can be removed.

Types and symptoms: how to recognize damage?

A closed fracture of the metatarsal bones resembles a bruise, so consultation with a doctor is required.

Doctors divide fractures of the metatarsal bones into 2 types:

• Traumatic, which occurs as a result of injury.
• Stress when bones break due to regular overuse of the feet. In this case, the symptoms are not clearly expressed and are manifested only by periodic pain and slight swelling.

Damage can be closed or open. Depending on the nature, the symptoms differ, and how is shown in the table:

Diagnostics

Diagnostics and qualified assistance are provided in a hospital setting. Therefore, the ambulance team picks up the injured baby and takes him to the emergency department.

After arriving at the hospital, the traumatologist or surgeon conducts a preliminary conversation with the child or parents to take an anamnesis. Only after this can he examine the injured limb, determine the severity of the injury, and the mechanism of its receipt.

An x-ray of the hand is required, on the basis of which the nature of the fracture is studied and the presence of damaged tissues and blood vessels is determined. It may happen that the x-ray does not give a clear picture, that is, the presence of a fracture is not determined.

In this case, a computed tomography scan is prescribed or an ultrasound examination of the bone is performed. Based on all the data obtained, an analysis is made and treatment is prescribed.

Diagnostic measures

Identifying a bone fracture in children begins with a medical examination. The traumatologist palpates the injured area. An X-ray examination is then performed to give an idea of ​​the condition of the bone.

The patient is placed on the table. The groin area, eyes and thyroid gland are covered with special protection. If necessary, the picture is taken in several projections. During the procedure, the child must take a stationary position.

If damage to the knee meniscus and cruciate ligaments is suspected, arthroscopy should be performed. This study is carried out using a specialized video camera. To administer it, a puncture is first made in the joint cavity.