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It’s best to have your doctor decide

After a summer full of events, and with the start of the fall sports season, it might seem like your kids never stop moving. Plus, with all of these activities, the occasional injury is sure to follow. 

But when an injury does occur, how can you identify the source of the pain and get the right help? 

“Two of the most common injuries children face are sprains and broken bones,” said Dr. Todd Holmes, director of Geisinger South Wilkes-Barre Emergency Medicine. “And though these are two totally different issues, it can sometimes be hard to tell them apart.”

Sprains are caused by the excessive stretching or tearing of the ligaments, which are strong bands of tissue that surround your joints and bones and help you move. The most common type of sprain is a sprained ankle. 

“Many of us have experienced a twisted ankle, whether it is from a fall or sudden movement playing sports,” said Dr. Holmes. 

Broken bones are very common with thousands of cases each year, but are often a much more severe injury. 

“Our bones are strong and a bit flexible, but with enough pressure they will still break—similar to a tree branch,” said Dr. Holmes. 

The difference between a sprain and a break
Though it may hurt like a broken bone, a sprain doesn’t damage your bones or joints. Your child may have heard a “pop” when the injury occurred, and is now experiencing pain, swelling, bruising and decreased movement but they are still able to control the body part and don’t appear to be bleeding. 

On the other hand, broken bones can take a variety of different forms. Many are marked by a deformity, where the limb looks out of place. In severe cases, the bone can pierce the skin. This is called a compound fracture. Movement with a broken bone is often extremely difficult or painful. 

“In the case of a stable fracture, the bone will be broken but remain in place, so you may not be able to tell the bone is broken just by looking at it,” said Dr. Holmes. 

Getting treatment

You can treat minor sprains at home by elevating the limb and applying ice to decrease inflammation. You may also want to give your child a pain reliever like acetaminophen. In more serious cases, your pediatrician may recommend a splint or brace. 

However, if you’ve iced and elevated the limb for a day or two and the swelling hasn’t gone down, it might be time to call your doctor, who may recommend an X-ray, or a trip to the emergency room or an urgent care center that’s equipped with X-ray.

“Though a bad sprain could mean your child’s joint stays swollen for several days, you’ll likely want to check with your doctor after a day or two if you’re not seeing in improvement in it,” said Dr. Holmes.

Tests may prove that your child actually broke a bone and should be treated immediately.

In most cases, the limb will be placed into a cast to immobilize the bone or a brace that allows minimal movement of nearby joints after confirmed the break with an X-ray. Traction, the process of realigning bones through gentle pulling, or external fixation, a surgical procedure where metal pins or screws to stabilize the bone, may also be needed for severe fractures.

“Getting medical treatment quickly is vital for broken bones,” said Dr. Holmes. “Continuing to use a broken bone can cause the break to worsen. The pieces may move further from one another or the sharp edge of a broken bone can pierce tissue.” 

Even minor untreated fractures can lead to chronic pain down the line, as your ligaments are forced to accommodate bones that may not be straight. 

Todd Holmes, MD, is an emergency medicine physician at Geisinger South Wilkes-Barre.

Doctor treating girl who has an ankle injury