AskThePedipod
Farokh Wadia
Musculoskeletal trauma/fractures
Mr Farokh Wadia, Consultant Paediatric Orthopaedic Surgeon
1 August 2026
Your child has sustained a broken bone and you need more information about it
What it is: This covers injuries to children's bones, joints, ligaments and soft tissues, including fractures. Children's bones differ from adults' because they are still growing and contain growth plates, which need particular care.
Signs and symptoms: Pain, swelling, deformity, reluctance to move or bear weight on a limb, or bruising after an injury.
Diagnosis: Clinical examination and X-rays. Some injuries involving the growth plate or joint surface may need further imaging such as CT or MRI.
Treatment: Many childhood fractures heal well in a cast or splint. Some, particularly those involving the growth plate or significant displacement, need realignment or surgical fixation to ensure proper healing and growth.
Outlook: Children have a remarkable capacity to heal and remodel bone. With appropriate treatment, the great majority recover fully.
When to seek advice: After any significant injury with pain, swelling or deformity, or if your child is unwilling to use a limb. Or if you get conflicting views about the right treatment.
FAQs
When does a child’s bone fracture require surgery instead of a simple cast?
A child’s bone fracture requires surgery instead of a simple cast if the broken bones are severely displaced, cross through a growth plate, fail to stay aligned, or break cleanly through the skin. Because children's bones are highly flexible and have a thick outer lining, many fractures can be managed with a standard plaster cast, but complex alignments need surgical stabilization to ensure normal growth.
Signs that an orthopedic injury requires urgent specialist review:
Growth plate involvement: Fractures crossing the growth zone need perfect alignment to avoid permanent limb shortening or bowing.
Severe displacement: Bones that cannot be safely manipulated back into position without internal support.
Surgical stabilization: Using smooth, temporary flexible rods (elastic nails) or pins to keep the fracture locked in place during healing.