Orthopedic Trauma Program

Trauma — from accidents, falls, even sports — can damage a child’s bones, muscles, joints, and nerves. As a Level 1 Pediatric Trauma Center, as designated by the American College of Surgeons, Boston Children’s Hospital has the resources and skills to care for your child if they have a traumatic orthopedic injury.

The effects of trauma depend on many factors: the extent of the injury and how it happened, for instance. While some sports injuries, like a clavicle fracture, often heal with observation and time, car crashes and other high-impact incidents can cause multiple serious injuries that require a higher level of care.

Boston Children’s Orthopedic Trauma Program offers comprehensive care for children of all ages with musculoskeletal injuries. We treat a range of traumatic orthopedic injuries, from small finger fractures to complex high-energy injuries. We also care for bone and joint infections, which often require hospitalization and even surgery in addition to antibiotics to treat the infection.

Our team is made up of specialists in each bone and muscle group:

• Feet, ankles, knees, and legs
• Hands, wrists, elbows, arms, and shoulders
• Hips and pelvis
• Spine
• Peripheral nerves

Trauma can affect systems throughout the body. Thanks to the extensive resources at Boston Children’s, we can quickly pull in the right experts to address any of our patients’ medical needs. For instance:

• If a child has a wound that’s not healing or scar tissue that’s limiting movement, we work with our colleagues in Plastic and Oral Surgery to repair the tissues and restore function.
• If a child’s bones are slow to heal, we collaborate with experts in Endocrinology and Bone Health to identify and address the underlying cause.
• If a child has lost mobility, our Pediatric Rehabilitation Medicine specialists can oversee their therapies to help them regain function.
• If a child needs surgery, the doctors in the Regional Anesthesia Program offer pain management techniques that minimize exposure to general anesthesia.
• If a child has been severely injured and needs critical care, our Medical-Surgical Intensive Care specialists can care for the most complex patients.

Trauma affects children and teens differently than adults. Children have unique types of fractures, are extremely resilient, and heal relatively quickly. Because children’s bones are still growing, it’s often possible to repair a child’s broken bone with less invasive techniques, and we strive to treat your child without surgery if possible.

At the same time, open growth plates can sometimes make injuries more complicated. In a small number of cases, a fracture that intersects a growth plate can lead to growth abnormalities.

We recognize the potential for growth disturbance after injury and know how to treat any limb-length or alignment problems that result from the injury. In some cases, we follow patients for a year or longer, watching for signs that the trauma has affected their longer-term growth — and intervene if it has.

As pediatric orthopedic clinicians, we’ll tailor your child’s care to their age and stage of physical development. We’ll always include you and your child in making care decisions. If needed, we’ll also engage child life specialists, social workers, and other resources to make sure that your child is taken care of from all angles.

Boston Children’s Hospital is at the forefront of innovation in orthopedic care, traumatic injuries in children, and how best to treat them. To this end, we have an active research program and participate in several multicenter research groups.

Ongoing research projects include:

• School accommodations and family hardship after pediatric orthopedic trauma
• Tibia fracture compartment pressure study
• Femur fracture time to OR study
• Multicenter studies on spine trauma

Multicenter study groups include:

• CORTICES (Children’s Orthopedic Trauma and Infection Consortium for Evidence Based Study)
• FACTS (Function After Adolescent Clavicle Trauma and Surgery): Treating adolescent clavicle fractures with surgery carries more risk than non-surgical treatment