Our fracture team is led by surgeons who specialize in the treatment of children’s bones, muscles and joints (pediatric orthopedists). The team also includes physician assistants, orthopedic technologists, nurses and pediatricians trained in sports medicine. Their goal is to get your child back to their usual activities as quickly as possible.
Hand Fractures Treatment Options
Your child’s treatment will depend on which bone they broke and which type of fracture they have. The finger and thumb bones (phalanges, fah-LAN-jeez), the wrist bones (carpals) and the long bones between the fingers and wrist (metacarpals) can break in several ways. The treatment that works best for one break may not be best for another break.
Your child’s doctor will consider many other factors, such as these:
- Whether the broken bone is lined up in a normal way or is out of position (displaced)
- Whether the broken bone is stable or it moves out of place easily
- How old your child is, because their stage of growth may affect how their bone heals
To get the best results, it’s important not to do more or less than needed. Most children’s hand fractures heal fine with simple methods, like splinting or casting. Some require surgery. Hand fractures can happen and heal differently in children than in adults. A team that focuses on treating children will carefully decide whether surgery is the best option for your child.
Splinting, buddy taping and casting
If your child’s X-ray shows a fracture but the bone is straight and in a good position, we may give them a splint to keep the bone in place while it heals.
For some breaks, buddy taping is an option. Buddy taping means taping two fingers together to keep broken phalanges from moving too much.
Sometimes a splint or buddy taping is all that your child needs while the bone heals. Based on which bone they broke and how severe the break is, we may need to put a cast on once swelling is under control. We apply casts if we think the bone may not heal well unless it stays in one position.
We also use casts if they can make your child more comfortable by keeping the broken bone still. This reduces the pain that comes if the broken body part is bumped or moved.
If your child’s X-ray shows their fractured bone is at an angle or in a bad position, the doctor will try to move the bone back into place (fracture reduction) before splinting, taping or casting. The doctor may be able to do this just by using their hands to move your child’s finger or hand (closed reduction). Before reduction, we give your child medicine to block feeling around their fracture (anesthesia) or to relax them (sedative).
Surgery for fractures
If closed reduction is not successful, your child may need surgery. We will make a small cut (incision) so we can see the fracture and move the bone (open reduction). In some cases, we use pins to keep the bone in place so it can heal correctly. Later we take out these pins at a clinic visit.
Most children with hand fractures do not need surgery. If your child does need an operation, our surgical staff can ensure that they receive the most appropriate surgery for their injury.
Dealing with Growth-Plate Injuries
Most growth-plate injuries will heal without affecting growth. The risk of problems depends on many factors, such as how serious the injury is, how old your child is and which bone they broke.
If your child has or might have a growth-plate injury, the doctor will ask you to watch for signs of growth problems. The doctor will also want your child to come back from time to time in the first one to two years after the injury. The doctor will examine your child, and your child may have X-rays to check for growth problems. For example, the finger that was broken may not be growing as fast as the other fingers or it may not be growing straight.
Some children who develop growth problems may need surgery to adjust the length of a bone or other care.