The most common bone fractures and tips on preventing them

Even with families staying closer to home this summer, fractures in kids are on the rise. Whether it is playing on a swing set, riding a bike or falling in the house, accidents happen.

“Bones are very strong, and have some flexibility,” said Dr. Jill Larson, assistant professor of pediatric orthopaedic surgery at Ann and Robert H. Lurie Children's Hospital of Chicago, “but, under enough stress or pressure, they will break.”

While there are well over 200 bones in a child's body, the most common fractures fall into five regions:

- The wrist or hand, which directly receives the force of the ground when a child naturally tries to break

a fall.

- The forearm (radius and ulna). When falling onto an outstretched hand, the rotational forces that move through the forearm can cause both forearm bones to fracture at the same or different levels.

- The tibia bone in the lower part of the leg. These fractures can occur from either a direct or sideways pressure, but most commonly occur from a “twisting” force.

- The elbow. The most common area of the elbow to fracture is the distal end of the humerus (the bone that connects the shoulder to the elbow) in an area known as the supracondylar region.

- The ankle. Rotational injures to the ankle can result in fractures or ankle sprains (ligamentous injuries). Both fractures and sprains can be painful with standing or walking and are associated with ankle swelling. An X-ray can help confirm if the ankle is fractured or sprained.

Some of these fractures are more common in certain age groups. For example, a non-displaced tibia fracture, or “toddler's fracture,” is quite common in children aged 9 months to 3 years, and a fracture of the supracondylar humerus (elbow) is most likely in children younger than 8. Ankle fractures are more prevalent in older grade-schoolers or teenagers.

Regardless of the age, there are some things children and teens can do to help make their bones stronger and more resistant to fractures. Diets rich in calcium and other nutrients, along with regular physical activity of at least 35 to 60 minutes a day, can help build strong bones and allow children to maintain a healthy weight.

“Studies have shown that overweight or obese children have higher risk for fractures, primarily due to increased stress on the bones and secondarily due to inactivity,” Larson said.

Additionally, Vitamin D is very important in building strong bones. When the weather is warmer, the sun can be a great source of Vitamin D, but in cooler months, it is critical to take a Vitamin D supplement.

Children in the Midwest should take up to 1000 IU (international units) of Vitamin D per day to prevent fractures.

“If your child is not a big milk drinker,” Larson said, “then you may want to consider a calcium supplement, as well.”

Overall, we know that accidents happen, but keeping our bones strong through diet, exercise and vitamin supplements are strategies to help minimize the risk of your child getting a fracture this summer season.

Children's health is a continuing series. This week's article is courtesy of the Ann and Robert H. Lurie Children's Hospital of Chicago.

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