How (medically) should a hairline fracture, in a 2 year old little boy (very active) be treated?

Question

My son was jumping on his bed and fell. He cryed that his foot was hurting, was limping, and his foot was getting a little puffy. I brought him to the emergency room. The doctor had an x-ray done, which showed no breakage. I was told to treat it like a contusion, but to keep an eye on it, and my son's behavior. A week later my son was visibly limping, there was bruising, and his foot was still a little puffy in the the bruised area. I brought him to the pediatrician. The Doctor told me that he suspects that even though it didn't show up on the original X-ray, my son has a hairline fracture. He then told me that I need to keep my son off of his feet for another 4-5 weeks. Then, he proceeded to wrap my son in an Ace bandage, stating that hopefully this woud encourage him to stay off of it. I asked the doctor if it should be casted, or atleast splinted, and he said he felt it not necessary. Shouldn't
a hairline fracture be splinted, at least?

Answer 1

For a very active 2 year old I would say after the swelling goes down it should be splinted. 2 year olds don't fully understand the concept behind "staying off" the injutred foot. He could cause more damage to his foot if it isn't protected properly.

Answer 2

In all first aid training taught by the Red Cross, US military, etc. the only time splinting is done is when it is an immediate injury and you suspect that the limb is broken. Then trained medical personnel remove the splinting and treat the injury as they decide what is wrong. Splinting isn't usually done then because casts are more durable and comfortable for the patient.

Since no one put a cast on your son's foot, it obviously wasn't needed. Hairline fractures usually will heal on their own if they aren't very large in size or they are not in a place critical for movement. The Ace bandage is all that is needed because there are no loose ends that have to be kept together. Casts are placed to keep the ends together so they don't cause further damage and they allow the ends to grow together to seal the break. The doctor obviously didn't think your son's injury was critical except that if you don't keep him off his foot then it could progress into something worse.

If you really feel that your kid's doctor missed something, then go get a second opinion. However, if the second doctor says the same as the first, then you have confirmation that your son's foot isn't that serious and if you follow the original directions, it will heal up fine.

Answer 3

There is always a trade-off between immobilizing a fracture and letting it heal without immobilization. Putting a foot in a cast for 4-5 weeks causes muscles to atrophy and ligaments and tendons to tighten. Sometimes the problems caused by a cast are bigger than the problem caused by the original fracture. On the other hand, some fractures won't heal unless they are immobilized - it depends on the location of the fracture and how severe the fracture is.

A good middle ground at this point would be to ask the doctor if he/she could write a prescription for a walking cast - which is an open boot that is worn like a shoe. Your son can wear the boot when he is active, and take it off at night. He can also do a little bit of walking without the boot to keep the muscles and ligaments in proper condition.

Answer 4

It's astonishing that a *rape case* involving an eight year old and two ten year old boys would make it to court given the physical impossibility of a *rape* in the first place. It is also unsettling that the girl was told by the judge that she had done nothing whatsoever wrong and not to forget that. ??? Since when is false accusation of rape an OK thing to do? There *may* be mitigating/aggravating circumstances (w/e way you want to look at it) - (perhaps) - but really - at this stage how does the judge actually know that she did *nothing wrong* given that two innocent kids have been dragged through a very public judicial process - and are still going through it as the trial continues - despite the girls recantation.