To understand the importance of completing fracture care it is important to understand that pediatric bones are different than adult bones and fracture/break differently.  Thus, why you should visit a pediatric orthopedic office!

Children’s bones have more flexibility, open growth plates and tend to heal faster than adult bones. Typically, total fracture healing time is 8-12 weeks versus months in an adult.

The objective of treatment is to maintain alignment to allow for healing and regain full function. Common factors that determine initial treatment and follow-up care include patient age, fracture pattern, fracture location, and level of displacement

  1. PATIENT AGE – this may influence splint/cast option, need for surgical intervention or follow-up. For example, toddlers often need longer casts to encompass a joint due to the shape of toddler extremities.
  2. PATTERN – Fracture pattern influences the stability of the fracture and directly impacts treatment and follow-up.
  3. LOCATION – this can be the specific bone involved or the location of the fracture within the bone.
  4. LEVEL OF DISPLACEMENT – this is in reference to the level of abnormal position of the fracture. This does not apply to all fractures. Also, the above-mentioned factors directly impact the acceptable amount of displacement and treatment.

TYPICAL FOLLOW-UP:

  • Return to clinic in four weeks for repeat x-rays out of cast/splint.
    • If adequate healing, activity advancement discussed, then often no further return visits are needed.
    • If inadequate healing, patient with continued immobilization and follow-up appointments scheduled until acceptable healing is achieved to allow activity advancement.

** Recommended follow-up appointments MUST be kept to receive an activity guideline with a full release date.**

GROWTH PLATES are spaces of growing tissue mostly located at the ends of long bones. They contribute to the length and width of bone and close at the end of puberty.  Growth plate fractures often occur because this area is softer and weaker.

  • A fracture may occur within the space alone or involve adjacent bone.
  • Damage to some growth plates may impact how the bone continues to grow. This could result in uneven bone growth or premature closure of growth plate.
  • Some growth plate fractures will require further follow-up with repeat x-rays every six months for up to two years post-fracture care to ensure health of growth plate.
    • Growth plate damage often has no symptoms therefore it is important to keep these appointments!


– Angie Harrish, CPNP