Toddlers are pretty durable. They jump, run, and climb constantly, perhaps crying for a few minutes if they take an unexpected tumble, then getting right back to it. One of the reasons toddlers are able to perform such wild acrobatic feats when they’re little is that their bones are springy and flexible. Toddlers’ bones also have a thick covering that allows them to better absorb the shock from a fall. This flexibility and extra padding together mean young children’s bones don’t break as easily as an adult’s bones.

Despite having such a resilient, pliable framework, however, it’s still possible for toddlers to fracture, or break, a bone. In fact, fractures are the fourth most common injury for kids under age 6, according to the American Academy of Pediatrics (AAP). Fortunately, toddlers also heal much faster than grown-ups. Let’s take a closer look at what you need to know about toddler fracture.

Why Toddlers Fracture Bones

Toddlers may break a bone for any number of reasons. In children, fractures commonly occur because of car accidents, falls, or sports or playground injuries. Other possibilities, sadly, are physical abuse and abnormal bone fragility. In children, most fractures occur in the wrist, the forearm, and above the elbow.

Toddler Fracture Symptoms

It’s not always easy to tell when your child has fractured a bone, particularly if they’re young enough that they can’t express what they’re feeling. Typically, you’ll be able to observe swelling or bruising, numbness or tenderness to the touch, and an inability or unwillingness to move. (It’s important to note that just because a child is able to move their limb doesn’t mean it isn’t broken.) Your child may also cry inconsolably from the pain. More obvious, serious toddler fracture symptoms may include a deformed or bent appearance in the limb, bone sticking through the skin, and a grinding or snapping noise at the moment of injury.

Toddler Fracture Treatment

What to Do at Home

If suspect your toddler may have a broken bone, you should contact your pediatrician or seek medical treatment immediately. Call 911 or your local emergency number if any of the following occur:

• Your child is unresponsive, isn't breathing, or isn't moving. Initiate CPR if there's no breathing or heartbeat.
• Your child is bleeding heavily.
• Your child experiences pain from even gentle pressure or movement.
• The limb looks distorted or bones are piercing through the skin.
• The tips of the injured limb, (fingers or toes), are numb or turning blue.
• You believe the neck, head, or back may be fractured.

Outside of these circumstances, you’ll probably need to take your child to the pediatrician’s office, urgent care facility, or emergency room yourself. To protect the injury and minimize movement, you’ll need to stabilize your child’s injury with a homemade splint until you arrive. Here’s how to do it:

1. Use scissors to cut clothing away from the injury.
2. Gently wrap a towel or dishcloth around the injured area, taking care not to move it much.
3. Put something firm, like a ruler or a tightly rolled magazine, next to the cloth to splint (support) the injury.
4. Fasten the splint with medical tape, scarves, ribbons, or even neckties. Take care not to tie it too snuggly in order to avoid cutting off your toddler’s blood circulation.

Apply a wrapped ice pack or cold pack to the injured area to help reduce swelling. Avoid giving your little one any food, drinks, or pain medication without first speaking with the doctor.

What Happens at the ER or Doctor’s Office

Your toddler’s physician will closely examine the injured area for tenderness, redness, and swelling and will typically order an x-ray to confirm the type and location of the fracture. Some fractures (such as stress fractures) don't show up on an X-ray until a few weeks after the bone starts hurting. Because a toddler’s fracture can be subtle using plain radiology methods, your doctor may also order additional diagnostic testing. This may include a computed tomography scan (CT, CAT scan), magnetic resonance imaging (MRI), or a bone scan. 

If the bone is broken, the doctor will likely ask an orthopedic specialist to put a cast on your toddler’s fracture. Alternatively, your little one may be placed in a splint instead (which is like a cast but not hard all the way around) and sent to an orthopedic specialist for a cast once the swelling has gone down, typically within a week.

If the orthopedist needs to set the bones back in place before casting them, your toddler will be referred to the emergency room where they will receive anesthesia intravenously. This medication usually lasts about 20 minutes – only long enough to set the bones back and place the cast. For a simple break in which no bone manipulation is necessary, the orthopedist will cast your toddler without anesthesia. In severe cases, surgery may be required before casting.

After the cast or splint has been placed, you’ll likely be sent home with pain medications for your toddler and instructions for follow-up appointments with the orthopedist until the bone has healed and the cast can be removed.

Toddler Fracture Healing Time

Young children have bones that heal much more rapidly than an adult’s bones. The exact amount of time depends on the location and severity of the fracture. For instance, a broken finger may only need a month to heal, whereas a fractured forearm or ankle may take anywhere from six to twelve weeks. A larger bone, like the femur, may take several months to heal. Your child’s doctor will remove the cast once the bone has healed. Until that time, stick to the doctor’s orders for caring for your toddler while they’re in the cast and try to keep them as comfortable as possible.

The Takeaway on Broken Bones in Toddlers

While it’s heartbreaking to see your toddler hurt, broken bones are a common part of childhood. With proper treatment, a broken bone typically heals well. Help your toddler follow the doctor’s recommendations. Within a few months, your little one will be back to all the daredevil activities they were doing before the injury.