Should Your Child See a Doctor?
- Injuries to leg
- Injuries to a bone, muscle, joint or ligament
Types of leg injuries
- Fractures (broken bones)
- Dislocations (bone out of joint)
- Sprains - stretches and tears of ligaments
- Strains - stretches and tears of muscles (e.g., pulled muscle)
- Muscle overuse injuries from sports or exercise (e.g., shin splints of lower leg)
- Muscle bruise from a direct blow (e.g., thigh muscles)
- Bone bruise from a direct blow (e.g., hip)
Pain severity scale
- MILD: doesn't interfere with normal activities
- MODERATE: interferes with normal activities or awakens from sleep
- SEVERE: excruciating pain, unable to do any normal activities, incapacitated by pain
When to Call Your Doctor for a Leg Injury
Call 911 now (your child may need an ambulance) if
- Serious injury with multiple fractures
- Major bleeding that can't be stopped
Call your doctor now (night or day) if
- You think your child has a serious injury
- Looks like a broken bone or dislocated joint
- Large swelling
- Skin beyond the injury is pale or blue
- Skin is split open or gaping and may need stitches
- Age under 1 year old
- Bicycle spoke or washing machine wringer injury
- Pain is SEVERE (and not improved after 2 hours of pain medicine)
- Won't stand or walk
- Has a limp when walking
- Unable to move leg normally
- Joint nearest the injury can't be moved fully (opened and closed)
- Knee injury with a "snap" or "pop" felt at the time of impact
Call your doctor within 24 hours (between 9 a.m. and 4 p.m.) if
- You think your child needs to be seen
- Pain not improved after 3 days
Call your doctor during weekday office hours if
- You have other questions or concerns
- No tetanus shot in over 5 years for DIRTY cuts (over 10 years for CLEAN cuts)
- Pain lasts over 2 weeks
Parent care at home if
- Bruised muscle or bone from direct blow
- Pain in muscle (probably from mild pulled muscle)
- Pain around joint (probably from mild stretched ligament)
Home Care Advice for Minor Leg Injuries
Treatment of Pulled Muscle, Bruised Muscle or Bruised Bone:
- Reassurance: Bruised muscles or bones can be treated at home.
- Pain: For pain relief, give acetaminophen every 4 hours OR ibuprofen every 6 hours as needed. (See dosage table). Ibuprofen is more effective for this type of pain.
- Local Cold: For bruises or swelling, apply a cold pack or ice bag wrapped in a wet cloth to the area for 20 minutes per hour. Repeat for 4 consecutive hours. (Reason: reduce the bleeding and pain.)
- Local Heat: After 48 hours apply a warm wet washcloth or heating pad for 10 minutes three times per day to help absorb the blood.
- Rest: Rest the injured part as much as possible for 48 hours.
Treatment of Mild Sprains (Stretched Ligaments) of Ankle or Knee:
- First aid: immediate compression and ice to reduce bleeding, swelling, and pain.
- Treat with R.I.C.E. (rest, ice, compression, and elevation) for the first 24 to 48 hours.
- Apply compression with a snug, elastic bandage for 48 hours. Numbness, tingling, or increased pain means the bandage is too tight.
- Apply a cold pack or ice bag wrapped in a wet cloth to the area for 20 minutes per hour. Repeat for 4 consecutive hours.
- Give acetaminophen (e.g., Tylenol) or ibuprofen for pain relief. Continue for at least 48 hours.
- Keep injured ankle or knee elevated and at rest for 24 hours.
- After 24 hours, allow any activity that doesn't cause pain.
- Expected Course: Pain and swelling usually peak on day 2 or 3. Swelling is usually gone by 7 days. Pain may take 2 weeks to completely resolve.
Call Your Doctor If:
- Pain becomes severe
- Pain is not improving after 3 days
- Pain lasts over 2 weeks
- Your child becomes worse
And remember, contact your doctor if your child develops any of the "When to Call Your Doctor" symptoms.
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This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.
Author and Senior Reviewer: Barton D. Schmitt, M.D.
Copyright 1994-2015 Barton D. Schmitt, MD. All rights reserved.