Wrist Injuries After Falls
Your child is running through the playground when suddenly they trip. As they fall to the ground, their arms shoot out in front of them to break their fall. Afterwards, they complain of pain in their wrists. Whenever your child has a bad fall and braces themselves with their arms and hands, it’s common to worry about a wrist fracture or other injury. In this blog, we will go over how to tell if your child has an injury and what you should do as well as what treatment you can expect.
A sprain is one possibility after a fall. Sprains occur when the ligaments in the body are stretched beyond their limits. Ligaments are connective tissue found throughout the body, and in the wrist there are ligaments that connect the arm bones to the hand bones. Sprains range from the minor, where a stretch or small tears occur in the ligament, to the severe, where the ligament breaks.
Symptoms will include pain and often swelling. There may be bruising and a feeling of tenderness around the injury. Your child may also feel a sense of weakness in their wrist.
A wrist sprain is often diagnosed clinically or by absence of a fracture on x-ray. For minor sprains, your doctor may suggest the RICE protocol: rest, icing the injury, compression of the injury (wrap with an ace wrap bandage), and elevation of the wrist and arm to reduce the swelling. For more severe sprains, your child may be given a splint to keep the wrist stable so it can heal properly. If the wrist pain continues for more than 3-5 days, without improvement, re-evaluation is warranted because children may have a fracture in their growth plate that does not show up on an initial x-ray.
Wrist fracture (buckle fracture)
When kids fracture their wrists, what they often get are what’s referred to as a buckle fracture. This is when the bone is compressed. Kids’ bones are more flexible and softer than adult bones, so kids’ bones may compress, rather than break in a classic fashion, when under sudden pressure such as a fall.
With a buckle fracture, the symptoms can be similar to a sprain so proper evaluation and a high index of suspicion is important. Look out for pain, swelling, decreased mobility of the wrist, and bruising. Your child’s doctor will likely order x-rays to determine the cause of their pain and swelling.
Buckle fracture treatment is either a cast or splint. Each has their advantages and disadvantages; your child’s treating physician can help you decide which is best for your child’s situation. Casts are better at completely immobilizing the injury and may result in less pain. Splints make it easier to bathe, allow some limited movement, and can be removed without the help of a doctor once the wrist is healed.
If you suspect your child has a wrist sprain or fracture, bringing them in to their primary pediatrician or a pediatric urgent care with x-ray capabilities is ideal. There, they can be checked out and diagnosed. If you’re in the Los Angeles area bring your child to MVP Pediatric and Urgent Care, where we have a state-of-the-art x-ray system for kids.