Broken Bones (continued)

For little ones who may be scared about getting an X-ray, it might help to explain the process like this: "X-rays don't hurt. Doctors use a special machine to take a picture to look at the inside of your body. When the picture comes out, it won't look like the ones in your photo album, but doctors know how to look at these pictures to see things like broken bones."

However, a fracture through the growing part of a child's bone (called the growth plate) may not show up on X-ray. If this type of fracture is suspected, the doctor will treat it even if the X-ray doesn't show a break.

Children's bones are more likely to bend than break completely because they're softer. Fracture types that are more common in kids include:

• buckle or torus fracture: one side of the bone bends, raising a little buckle, without breaking the other side
• greenstick fracture: a partial fracture in which one side of the bone is broken and the other side bends (this fracture resembles what would happen if you tried to break a green stick)

Mature bones are more likely to break completely. A stronger force will also result in a complete fracture of younger bones. A complete fracture may be a:

• closed fracture: a fracture that doesn't break the skin
• open (or compound) fracture: a fracture in which the ends of the broken bone break through the skin (these have an increased risk of infection)
• non-displaced fracture: a fracture in which the pieces on either side of the break line up
• displaced fracture: a fracture in which the pieces on either side of the break are out of line (which might require surgery to make sure the bones are properly aligned before casting)

Other common fracture terms include:

• hairline fracture: a thin break in the bone
• single fracture: the bone is broken in one place
• segmental: the bone is broken in two or more places in the same bone
• comminuted fracture: the bone is broken into more than two pieces or crushed

Getting a Splint or Cast

The doctor might decide that a splint is all that's needed to keep the bone from moving so it can heal. Whereas a cast encircles the entire broken area and will be removed by the doctor when the bone is healed, a splint usually supports the broken bone on one side.

When the doctor puts on a splint, a layer of cotton goes on first. Next, the splint is placed over the cotton. A splint may be made of stiff pieces of plastic or metal or can be molded out of plaster or fiberglass to fit the injured area comfortably. Then cloth or straps (which usually have Velcro) are used to keep the splint in place. The doctor might need to readjust the splint later, or you and your child might get instructions on how to do it at home. Your child might be allowed to remove it carefully to take a bath.

However, most broken bones will need a cast. A cast, which keeps a bone from moving so it can heal, is essentially a big bandage that has two layers — a soft cotton layer that rests against the skin and a hard outer layer that prevents the broken bone from moving.