What is fracture?

Fracture surgery is the term utilized for a broken bone. It occurs in young children since small kids have bones that are developing and not yet completely created. It’s not breaking news that kids break bones.

Does my child need fracture surgery?

Grown-up children are able to tell you where they are painful and can describe what happened to cause the injury but It can be more difficult to identify a fracture in infants or toddlers. They may cry and not use the affected area, but there may be no obvious injury.

 Your child might have a fracture that need surgery if she/he has the following symptoms

• pain or tenderness at the injury site

• swelling or redness around the injury

• deformity (unusual shape) of the injured area

• not wanting to move or use the injured area.

What should I know before surgery?

The surgery can be completed in two ways: open or arthroscopic. The process used will depend on why your child needs surgery.? 

Open surgery. This is the traditional method of doing surgery. It’s usually done through 1 cut (incision). This incision is large enough for the surgeon to have a direct assessment of the part to be operated on.

Arthroscopic surgery/Arthroscopy). This is done through numerous smaller incisions. A tube that is called arthroscope have a small video camera and a light is introduced through incision. It will give the surgeon a clear understanding of the area being operated on. Minute surgical tools are then place through other slight incisions to do the surgery.

• It’s crucial to have a meeting with your child’s orthopedic to talk over all of your worries and get your thoughts straight so you can confidently teach your child.
• Let your child know that anesthesia is a medication to keep them comfortably sedated during the procedure, assuring them it won’t cause any pain. 
• Your child must follow fasting guidelines provided by your doctor.
• In addition, your doctor may ask you to stop taking other medicines that may interfere with clotting.

 The day of surgery

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Get to the hospital on time. You’ll be asked to fill out certain forms.

Your child will be given a gown to change into.

A provider called an anesthesiologist or nurse anesthetist will meet with you. They’ll discuss the medicines that will help your child sleep through the surgery. Be sure to ask any questions you have.

You may be asked by several people to confirm which part of the body is being operated on. This is routine and is for your child’s safety. The body part may also be marked with a pen.

Your child will be given an IV (intravenous) line. This gives your child fluids and medicines. Depending on the age of your child, the IV line may be put into the arm or the hand. The IV may be started after your child is asleep.

Your child may also need: X-rays, MRI,CT scan. These test uses X-rays and a computer to make full pictures of the body. 

 Doctors and nursing staff will give medicine to determine if your kid is eligible for surgery. For example, if your child has a fever, they will not be operated on due to the danger of infection. After that, they will transport your child to the surgery room. You will wait until the procedure is completed.
• After surgery, your kid will be monitored in a recovery area before being transferred to the ward, where you can meet with them. He or she would progressively become completely aware in 3 to 4 hours after being transferred to ward.

• Your physical presence close to your child on the day of surgery will comfort them that everything will be well.
• Confidently speak with your youngster to help them feel comfortable.
• To put your kid to sleep, the doctor will prescribe a general anesthetic, which is a medicine to keep them sedated.
• The doctor will remove the adenoids from your child’s mouth while they are asleep Your child won’t require stitches. The surgery will take You will be allowed to visit your kids as soon as they are entirely awake.
• A staff member from the surgical waiting room will accompany you to see your child.

Your kid will be continuously observed in the nursing unit after surgery.

• Your youngster will be urged to consume fluids orally. Your youngster will begin with sips of clear fluids (transparent liquids), ice chips, or freezes. Once your child can take sips, they can start drinking liquids from a cup.
• Your child’s temperature will be monitored routinely. 
• Your kid may get pain medication as required.
• The nursing team will monitor your child for vomiting or bleeding.
• Nurses will notify doctors if issues arise. When your kid is completely awake, they can stand up with assistance to use the restroom.

 If your kid experiences discomfort following the procedure, they will be given pain medication as a liquid to drink.

• Your child should have relatively little discomfort following the procedure.
• Your kid might be allowed to return home on the same day on the other hand in some surgeries like hip or knee replacement required a hospital stay for some days.
• Most children are ready to leave the hospital after one day in the nursing unit. Young people may need to stay for a lengthy amount of time.
• It would be best if you took your child home in a vehicle or taxi. Avoid taking your youngster home by bus or tube for their comfort and safety.

Healing process

Broken (fractured) bones heal quite quickly in children, so they are usually only put into a cast for 4-8 weeks. By this time, the bone has had time to lay down a thick layer of new bone called “callus” around the fracture to hold it in place. You may be able to see and/or feel this hard “knot” or “bump” of the callus. Over the next several months, the bone continues to heal, removing the rough edges, remaking the hard outer covering and the marrow inside, and removing the extra layers of callus. During this “remodeling”, the body can straighten the fractured bone by laying new bone on the inside edge, and taking away bone on the outside of the angled area. In young children, bones can remodel fairly large angles, healing to appear completely normal within one to two years.

After the cast is removed

After the cast is removed, it is normal for there to be some discomfort in the bones and joints that were immobilized, for the arm or leg to be smaller than the other side, and for the skin to have some changes (dry skin and more hair).

A few baths in warm water will soak off the dry, flaky skin. This may take a few days, but be patient and avoid scrubbing the skin. You may apply some lotion to soften the skin, if desired. The hair will return to normal over several months.

The casted area may be tender for a few weeks. The child should avoid jumping, climbing, running or activities with a high risk of falling for a period of time after the cast is removed. This also includes sports

What care can I provide to my child at home?

• Pain

When nursing to a fracture at home, it is crucial to monitor your child’s pain, elevate the damaged area to decrease swelling, and follow the doctor’s directions for cast care. It is essential to keep casts and splints dry at all times.

Ensure your child does not sleep with their sling on by removing it before bedtime. Elevate the damaged area for at least the initial three nights (or longer if advised by your doctor) by using an additional pillow or folded blanket.

You may offer your youngster pain medication.

You may be given a prescription for pain medicine before leaving the hospital. Follow your chemist’s dosage directions. Although some prescription pain drugs might be effective, they may have potentially dangerous effects if not taken correctly.

• Nutrition 

After a fracture, your child bone needs to rebuild.

For this purpose you should give your child best nutrition from your plate, not from a pill.

• Look to replace common foods with high-calcium versions. Buy almond butter instead of peanut butter or calcium-fortified orange juice instead of regular juice.
• Give Kids calcium it will repair their broken bones. You can give  calcium to your child in the form of cheese, cottage cheese, yogurt, nuts, seeds, beans, soy products, and fortified cereals.

• Physical Activities

Your child should stop physical activities for the time being  to prevent any damage to the plaster cast, which could cause the fractured bone to shift out of alignment and hinder proper healing. 

• Your youngster should restrict their activities for four to eight weeks following the procedure. Please discuss with your doctor when it will be safe for your youngster to resume playing contact sports.

Physiotherapy

Following a fracture, children often recover strength by slowly engaging in mild physical exercise and play. Physiotherapy is generally unnecessary. Most children do not need physical therapy to walk or move normally again. Routine activities and play are usually enough for children to return to normal within a few weeks to months. Following a joint fracture, it may be helpful to do gentle exercises twice a day. You can have the child move the healing extremity through all of its motions, using the other arm or leg to judge what normal is. Children who do not regain normal motion after a month or two should be rechecked. Your doctor will provide detailed guidance on the timing and manner in which your child can resume sports activities, often around four to six weeks following the removal of the cast.

Follow up medical appointment

Your child may have a follow-up appointment scheduled one to two weeks after the injury, following the consultation with your GP or doctor. Attending this session is crucial to monitor your child’s fracture and verify the progress of bone healing. Your doctor will inform you if your kid needs additional follow-up appointments or tests. Your child’s local GP can handle the continued follow-up for most small fractures. Some fractures may necessitate a follow-up X-ray and evaluation by an orthopedic surgeon to determine the duration of time your kid will need to wear the cast. 

Take your child to your GP or local hospital immediately if the cast is cracked, soft, too loose, too tight, or has rough edges that cause discomfort, if you suspect an object has been inserted into the cast, if there is a foul smell or discharge coming from the cast, if your child’s pain is getting worse, or if you have any other concerns.

If your child wears a cast or splint 

If your child’s cast causes tingling or numbness, contact their healthcare professional. 

• Cast feels too tight or loose.
• A rash appears underneath the cast or splint.
• Fingers or toes swell, feel chilly, or turn blue/gray.
• Cracks or rough edges on the cast or splint might cause pain.
• The cast or splint becomes damp.

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