Bone, Joint and Muscle Conditions
What are hip fractures?
A hip fracture is a break in 1 or more bones of the hip or pelvis.
In a growing child’s hips and pelvis, the most common place for a fracture is the attachment point. This is the place where the muscles attach to bone. In children, the attachment point is not fully formed yet, and so it is a weak point.
If a child moves their legs very suddenly and forcefully – for example, during a fall or while playing sports – the muscles that attach to the hip or pelvic bones can pull away and break the bone.
Fortunately, most hip fractures in children heal without a problem. Your child will have to give up some regular physical activities for about 6 weeks. Some children may need surgery to repair a hip fracture.
Hip fractures in children
Any child can get a hip fracture, though they are rare in very young children. For children, hip and pelvic fractures usually happen during automobile accidents or during snowboarding or bicycling accidents.
Hip Fractures at Seattle Children’s
Because the hips are the body’s connection to the legs, it is important to diagnose and treat injuries to them correctly. At Seattle Children’s, hip fractures make up about 10% of the total number of fractures we see each year.
We treat the full range of bone, muscle and joint conditions – from the simplest fracture after a fall on the playground to the most complex or rare disorders, like skeletal dysplasia and metabolic bone diseases.
We have a wide range of experience in treating children with all types of pelvic and hip injuries and fractures. The Fracture Program offers a Friday Fracture Clinic to provide dedicated, quick access for children or teens who need evaluation, treatment or follow-up care.
The surgeons, doctors, nurses and others in our Fracture Program are specially trained to diagnose and treat pediatric and adolescent injuries. Patients come to us from around the country for care.
Many fractures that require surgery in adults can get better in children without surgery. Pediatric orthopedists have the experience to know when it is necessary to operate on a child’s fracture.
Our experience with these injuries enables us to choose the treatment that will lead to a good recovery with few complications.
We see your child as a whole person. Infants, children and teens are still developing, so they may need different care than adults do, like treatment that takes their growth plates into account. Here, your child’s team has special training in the medical, surgical, emotional and social needs of young people.
We have the largest group of board-certified pediatric radiologists in the Northwest. Our radiologists have special expertise using ultrasound to look for bone and joint changes so we can work with your child to help prevent future problems. If your child needs imaging that uses radiation, we use the lowest amount possible to produce the best image. We also have a 3D low-dose radiation X-ray machine, called the EOS, for safer full-body 3D images.
To restore or improve your child’s health, function and quality of life, we often use nonsurgical methods (like medicines, physical therapy and braces), recommending surgery only when we believe it will give your child the best results.
Many of our pediatric orthopedic surgeons have expanded fellowship training in areas such as:
- Foot and ankle conditions
- Sports medicine
- Upper extremity surgery
- Limb differences
- Neuromuscular diseases
- Skeletal dysplasia
- Spine problems
Symptoms of Hip Fractures
Signs that your child’s hip may be broken include:
- Severe pain
- Swelling, bruising or bleeding
- Limb or joint looks out of place or the wrong shape
- Numbness and tingling
- Unable to move the hip
Diagnosing Hip Fractures
If your child has a mild injury around the hip or pelvis, the pain usually goes away after a few days. If the pain does not go away, your child should be evaluated by an orthopedist, and probably should have X-rays.
If your child has severe pain or pain that prevents them from taking part in their usual activities, your child’s doctor will take X-rays to look for fractures.
If the doctor does not see an injury on the X-rays, they may ask your child to have a bone scan to see if they can find a subtle fracture.
The doctor will also look for other problems that can cause pain such as:
Some problems that can cause pain can become serious if they are not found and treated early.
Treatment Options for Hip Fractures
Hip fractures require surgery or a cast, and sometimes both, to prevent the bones from shifting and causing permanent damage. Casts alone, without surgery, usually are used only in children younger than age 5 or so. Young children rarely get hip fractures. Their hip bones are more flexible than the hip bones of adults and are less likely to fracture.
Surgery for Hip Fractures
If your child’s X-rays show the break is bad or the hip is broken in several places, the doctor will recommend an operation to put the bone back in place. Most children with hip fractures who are older than age 5 need surgery.
During the operation, the doctor puts screws or pins in the bone to keep it in place so it can heal properly. Some children need to wear a cast after surgery to keep the broken bone in place and protect it as it heals.
Our doctors do both minimally invasive procedures and open surgeries to treat broken hips, depending on the nature of the break.
In a minimally invasive surgery for hip fracture, the doctor makes 1 small cut (incision) on your child’s hip. Then, using X-ray guidance, the doctor puts screws or pins across the break.
In an open reduction for hip fracture, the doctor makes a larger cut on your child’s hip. This lets the doctor see the bone so they can put it back in place.
If your child has surgery for a hip fracture, they will most likely be in the hospital about 3 or 4 days.
Sometimes, doctors use fiberglass body casts called hip spica casts in addition to surgery. The cast gives your child’s hip extra protection. Your child will wear the cast for about 4 to 6 weeks. If your child needs a cast, the medical team will give you instructions on how to care for your child while they are wearing the cast.
After your child is treated for a hip fracture, their doctor will closely monitor them for at least a year to make sure they are healing well.
If you have questions about hip fracture treatment, call our Orthopedics and Sports Medicine Department at 206-987-2109. If you would like an appointment, ask your child’s primary care provider for a referral.
Providers, see how to refer a patient.