Fracture of the lower forearm of a child (”wrist fracture”)
Fractures of the lower forearm are very common in children. A typical situation is a fall on an outstretched hand, for example while playing or playing sports. Children's bones are remodeling and have a great ability to repair themselves as they grow, which makes treatment different from that in adults.
Types of fractures and their treatment
The doctor will determine the type of fracture from the X-ray. The course of treatment depends on the type of fracture and the child's age:
Wrinkle fracture (Torus):
What is it? The bone is not actually broken, it is just "snatched" or wrinkled on one side.
Care: This is a completely stable injury. It is treated with a brace (orthosis) or a plaster cast for 1–3 weeks, mainly due to pain. No X-rays are needed.
Willow stick fracture (Greenstick):
What is it? One side of the bone is broken and the other side is bent (like a fresh branch).
Care: If the position is poor, the fracture needs to be straightened. It is more unstable than a crease fracture, so the position is often checked with an X-ray after about a week.
Cross fracture:
What is it? The bone is completely broken.
Care: If the ends of the bones have shifted significantly, they are put back in place (reposition). In young children, even large shifts can correct themselves as they grow, but visible misalignment is usually always corrected.
The Power of Growth (Remodeling)
A child's skeleton corrects misalignments with amazing efficiency. This is called remodeling.
For children under 5 years old Up to a 35 degree tilt in the direction of wrist movement is acceptable.
For ages 5–12 A tilt of about 25 degrees is acceptable.
The older the child, the more precise the position is sought because there is less growth left.
Surgical treatment and metal spikes
If the fracture is very unstable or the position is poor, the fracture will be straightened in the operating room under anesthesia.
Spike: The fracture can be supported with smooth metal pins (K-pins) inserted through the skin. They prevent the fracture from shifting position inside the cast.
Growth plate fractures: If the fracture damages the joint surface or growth plate, it requires particularly careful treatment and often surgery to prevent disruption of bone growth.
Cast treatment and home instructions
The fracture is usually supported with an individual with a plaster trowel, which leaves the fingers and elbow free to move.
Do this at home:
Pain medication: Give your child painkillers (e.g. paracetamol or ibuprofen) regularly for the first few days.
Business: Encourage your child to move their fingers actively right from the start.
Observation: Contact a doctor if the fingers turn blue, cold, numb, or if the child has severe pain that is not relieved by medication.
When is monitoring needed?
Wrinkle cracks no need to re-photograph.
Willow cane and transverse fractures usually checked with an X-ray after 7–10 days to ensure that the position has not changed in the cast.
Pinched fractures is photographed before the spikes are removed (usually at 3–4 weeks).
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