Treatment of Fractures in Children

Non-Surgical Treatment

The majority of children’s fractures can be treated without open surgery. Non-surgical treatment commonly involves:

• Casts
• Braces/Splints
• Boots

Due to the remodelling potential of children, even if the bones are not perfectly aligned, over time as the child grows they will straighten out, this is known as “remodelling”. This process can take years to be complete. The key considerations for us to decide whether or not a fracture will remodel sufficiently are:

• Age of the child
• Amount of displacement
• Which bone is affected
• Which direction the bones have shifted

The rate of remodelling in a child is inversely related to age. In younger children, remodelling is rapid and often complete. It is slower in older children and much slower in adolescents.

Surgical Treatment

Surgical treatment is sometimes required for children’s fractures to assist in realigning bones and joints to allow effective healing to occur. This may involve:

• Pushing the bones back into place under anaesthetic, without opening the skin/without incisions
• Mini open (keyhole) manipulation and casts
• Closed/Open reduction with fixation