Overview
what it is and why it mattersChildren's broken bones aren't just smaller versions of adult fractures — they behave differently. Kids' bones still have soft growth plates (cartilage zones near the ends where new bone is forming), they bend more before they break, and they heal and remodel themselves to a degree adult bone can't touch. When a fracture goes through or near a growth plate, your provider classifies it on the Salter-Harris scale from I to V to predict how it'll heal. Types I and II — the most common — usually do beautifully. Types III and IV cross into the joint surface and have to be put back in exactly the right position. Type V is a crush of the growth plate itself and carries the real risk of the bone stopping its growth on that side.
Kids' bones can also bend or buckle without snapping all the way through — patterns called greenstick (one side cracks while the other side bends) and torus or buckle (the bone crinkles like a soda can) — that you basically don't see in adults. Both heal well in a cast without surgery.
Symptoms
what you or your child may notice- Pain at the injury site — your child will cry or pull away when you touch the area, or refuse to move it at all.
- Swelling and bruising — the area puffs up quickly, sometimes within minutes, and may turn purple.
- Not using the injured limb — a toddler stops crawling or walking; an older child cradles the arm or won't put weight on the leg.
- Visible bend or deformity — the arm or leg looks crooked compared with the other side.
- Tenderness right at the growth plate — pressing directly over the end of the bone (near the joint) reproduces sharp pain, suggesting the fracture runs through the growth plate.
Diagnosis
exam first, imaging secondX-rays in two views are the starting point. Because growth plates can look just like fracture lines on a kid's X-ray, we sometimes also X-ray the uninjured side to compare. A CT scan adds detail when the break runs into a joint surface. An MRI shines for growth-plate injuries because it shows the cartilage that doesn't show up on X-ray.
Treatment Path
how care progresses at OSI1
Cast immobilization
Most kids' fractures — including most growth-plate injuries — heal beautifully in a cast. Children's bones reshape themselves as they grow, so they often correct small alignment imperfections on their own.
2
Splinting
Right after the injury we use a splint instead of a full cast — the leg or arm needs room to swell. Once swelling settles in a few days, we swap it for a cast.
Surgical Options at OSI
if non-operative care isn't enoughSurgery is reserved for fractures that cross the joint surface and need to be put back in exactly the right place (Salter-Harris III and IV), fractures pressing on a nerve or blood vessel, unstable forearm breaks, and most thigh-bone (femur) fractures in older children.
Providers Who Treat Pediatric Fractures
sports-medicine team
Further Reading
authoritative sourcesExternal patient-education references and related OSI pages for additional background: