Conditions + Treatments

Fractures

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What is a fracture?

A fracture is a break in the bone that often occurs when more force is applied to the bone than the bone can withstand.

Fractures are classified as either open or closed. An open fracture, also known as a compound fracture, occurs when the broken bone breaks through the skin. Open fractures are rare but have risk of infection if not treated appropriately. A closed fracture, also known as a simple fracture, occurs when the bone is broken, but the skin is still intact.

What are the different types of fractures?

When the bones stay in alignment they usually are cared for with a splint, brace or cast, immobilizing the injured bone to promote healing and reduce pain and swelling. Examples of these fractures are:

  • Single non-displaced fracture: The bone cracks or breaks but stays in place.
  • Stress (hairline) fracture: Tiny cracks in the bone that are usually caused by overuse or repetitive stress-bearing motions. These are common in children who take dance or run track.
  • Torus or buckle fracture: One side of the bone bends (buckles) upon itself without breaking the other side. This is a common injury with simple falls.

Fractures

Sometimes the injury is more urgent and requires surgery to put broken bones back into place. Examples of these fractures are:

  • Comminuted fracture: A bone has broken into more than two pieces and they do not align properly.
  • Compression fracture: The bone collapses under pressure. This is most serious when it involves a joint surface.
  • Displaced fracture: Ends of the broken bone come out of alignment. Surgery is usually needed to realign bones.
  • Greenstick fracture: A portion of the bone is broken, causing the other side to bend. (resembles breaking a branch from a tree, cracking on one side but staying partially intact on the other)
  • Segmental: The bone is broken in two places in a manner that leaves at least one segment floating and unattached.
  • Single fracture: The bone is broken in one place but into two pieces

Types of fractures

Growth plate fractures are unique to pediatric patients. Children have open-growth plates (areas from which bone grows) at each end of their long bones. Injuries to these growth plates are common and, in rare cases, can result in limb-length discrepancies or angular deformities.

Growth plate fracture

How are fractures in children different from fractures in adults?

A child's bone differs from adult bone in a variety of ways.

Flexible bones

A child's growing bones are bendable and resilient, which means they tend to buckle or bend a lot before breaking. This is the reason for the unique fracture patterns seen in children and not in adults. “Greenstick” and “buckle” fractures are two examples.

Faster healing

A thick layer of connective tissue (periosteum) surrounds a child’s bones, defending the bone against injury and harm. This tissue also produces blood supply to the area of a fracture. The body uses this supply of blood to replace damaged cells. Periosteum in adults tends to be much thinner, resulting in a slower healing process.

Vulnerable growth plates

Children have open-growth plates (areas from which bone grows) at each end of their long bones. Injuries to these growth plates are common and, in rare cases, can result in limb-length discrepancies or angular deformities. In performing surgery on broken limbs in children, surgeons must consider and account for these growth plates.

How we care for fractures

Every year our Orthopedic Center treats thousands of children, adolescents and young adults with fractures of all complexities. Our pediatric expertise allows for precise diagnosis of conditions related to the growing musculoskeletal system and development of optimal care plans.

At our Orthopedic Urgent Care Clinic we offer fast access care for injuries not serious enough to need emergency room care at four convenient locations — Boston, Lexington, Waltham and Weymouth.

We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”
- Sandra L. Fenwick, President and CEO

Boston Children's Hospital
300 Longwood Avenue, Boston, MA 02115
For Patients: 617-355-6000
For Referring Providers: 844-BCH-PEDS | 844-224-7337

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