Barts and The London Children's Hospital | For patients, families and carers | Health tips | Health tips - orthopaedic advice
Health tips - orthopaedic advice
Q. How can I make sure my child has healthy bones?
Q. Will my child’s fracture heal properly?
Q. When and how will the plaster come off?
How can I make sure my child has healthy bones?
Answered by Mr Matthew Barry, Consultant Orthopaedic Surgeon.
Almost all children have normal, healthy bones. Healthy bones need to be used and well supplied with vitamins and calcium. So to keep your child’s bones strong and healthy, make sure they have a well-balanced diet with plenty of fruit and vegetables and a good intake of calcium and vitamin D.
Regular exercise will also help to strengthen their bones. Weight-bearing exercises such as running, and playing football, netball and cricket will help to increase your child’s bone density.
It is particularly important to have a healthy diet with enough calcium during childhood and adolescence as this is when bones are developing.
Make sure your child has plenty of fruit and vegetables for vitamins. Milk, a good source of calcium, is also very important so encourage your child to have milk as part of a balanced diet. An adequate intake of calcium is not only important for healthy bones in children but also helps to prevent osteoporosis and fractures in later life.
Vitamin D helps the body use calcium and deposit it in bones and teeth. Good sources of vitamin D include milk and milk products, oily fish such as salmon, tuna and sardines, and sunlight. The action of sunlight on the skin is very important to the production of Vitamin D in the body.
Will my child’s fracture heal properly?
Answered by Mr Matthew Barry, Consultant Orthopaedic Surgeon
Yes. Fractures (broken bones) in children usually heal without any problems. Even if at first the bone heals with a small amount of bend or angle at the break, the bone will straighten out as it grows.
Fractures in children tend to be different to those in adults as the bone is softer and more able to bend. Greenstick fractures, where the bone bends rather than breaks completely, are most common and they heal more easily.
Treating a fracture involves lining up the ends of the broken bone properly so it heals in the correct position. If your child has a greenstick or simple fracture (when the bone breaks in one place but does not penetrate the skin), the bone will be held in place with a plaster cast.
If your child has a more complicated fracture or if it has penetrated the skin, aligning the bone will involve surgery to pull the bones into better alignment. Once in the proper position, the ends of bones are held in place while they heal, either with plaster or other fixing devices such as steel pins.
Most broken bones heal properly once they are in the correct position. The time it takes will depend on the type of fracture your child has and the bone affected, although it normally takes about two to eight weeks for a bone to heal and the plaster is removed. Physiotherapy is occasionally needed to build up strength and restore mobility, although in most children, physiotherapy is not required.
When and how will the plaster come off?
Answered by Mr Matthew Barry, Consultant Orthopaedic Surgeon
The plaster cast is removed when the fracture has healed, which takes about four to six weeks, but this can vary a lot, depending on the age of the child and the type and position of the fracture. Assessment of fracture healing is done by looking at the x-ray or simply by clinical examination.
The cast is removed with either scissors or a plaster saw. The plaster saw does make a lot of noise and this can be frightening for children (and adults as well!). The saw works in such a way that it cuts the cast but it does NOT cut skin. The saw works quickly and most casts can be removed in less than a minute.
Until the plaster cast comes off, children may find it uncomfortable especially as the skin under the cast can feel itchy. It is important that your child does not try to scratch their skin by sticking something down the cast such as a pen or ruler. This can damage the skin and cause an infection and the object may break off and become trapped under the cast, which can cause a pressure sore under the cast. If the skin is itching, you could try Piriton, an antihistamine, which helps to relieve itching. Talk to your pharmacist about the dose your child would need.
When the plaster comes off, the skin often looks very unhealthy with a lot of dead skin that has built up under the cast. The skin itches and if possible, children should not scratch their skin too much because the skin can be damaged. It is best to wash the skin in the bath and apply a simple skin moisturiser. Very quickly, within a few days, the skin will be much more healthy.
