Treating Common Injuries in Kids

Published December 13, 2017

Whether it’s on the playground, on a sports team or at home, falling and getting injured is just part of being a kid. The good news is that even broken bones tend to be mild injuries, and can heal smoothly and quickly. We asked Dr. Christopher Raffo, an adult and pediatric sports medicine specialist at our Maryland Orthopedic Specialists care center,  to share what parents need to know know about common kids’ injuries and treatments.

What are the most common kids’ injuries you see? Do you treat them differently than adult injuries?

We do treat pediatric injuries very differently than adult injuries, because children have open growth plates and the pediatric bone behaves very differently than the adult bone. Fortunately, this means that children tend to get less severe injuries. For example, a distal radial fracture is the most common fracture that children sustain – typically from falling – and it usually needs just a cast or a brace for a few weeks to heal. In contrast, adult fractures often require surgery.

Children do sustain serious elbow fractures, called supracondylar fractures, which can be complex because the elbow growth plate is only partially visiable on xray.  These are the classic "fall from a monkey bar" injuries.   Fortunately, little kids don’t usually get serious ligament injuries, such as a torn ACL. Instead, they get a lot of joint strains and are prone to muscle strains as they go through a growth spurt. Minor ankle fractures are also super common. It’s not necessarily more complicated to treat a developing child than an adult, but they tend to sustain injuries that are unique to kids. Another unique feature of children’s bone is the tremendous ability to heal and reshape the bone as it grows. Even moderate deformities can completely resolve. 

At what age do children begin to experience more severe, adult-like injuries?

Teens get to adult mass and adult strength at around age 14. They still have open growth plates and are still developing at that age. The injury severity comes down to the amount of energy transferred. Energy is related to mass and velocity, so when a 40-pound child runs slowly into another child, there’s not a lot of energy transferred and injuries tend to be minimal. Contrast that with a 240 pound athlete running at division I football speed, and significant energy transfers. Thus, the injuries tend to be much more serious. That’s why we see a lot of 14 to 18-year-olds with torn ACLs, but it’s rare to see an 11-year-old with that injury, even if they play the same sport.

With that in mind, what does the typical treatment look like for those injuries?

Obviously, it varies with the injuries.  For sprains and strains, it’s important to rest and immobilize the area.  For many of the fractures, the young athletes can still play sports with a cast. It's okay to play through the pain for some injuries, and others it isn't.

Is there any way to prevent the more serious sports injuries?

Unfortunately, we have seen a major shift in sports participation in the last 20 years. When I was a child, most athletes played multiple sports and each season was a few months. Now there is increasing pressure to become a single sport athlete, earlier and earlier, and to play on multiple teams. As a result of this increased exposure, major injuries are on the rise, as are overuse injuries.

Any tips for parents to discern the severity of a child’s injury, and whether or not they should seek medical treatment?

In general, they should consult a healthcare professional for injuries. No one has x-ray vision, and it can be hard to tell if a child sustained a bruise or broke a bone. If there’s any case of deformity, significant swelling, or an inability to bear weight, the injury should definitely be evaluated by a doctor.

Christopher Raffo, M.D., is an adult and pediatric sports medicine specialist at the Maryland Orthopedic Specialists care center. He is also certified in orthopedic surgery and has a special interest in arthroscopic shoulder and arthroscopic knee surgery. He earned his medical degree from Georgetown University and completed his residency at Georgetown University Hospital, with a fellowship at New England Baptist Hospital in Boston. Previously, Dr. Raffo has served as Head Team Physician for the Catholic University Cardinals and Assistant Team Physician for the Boston Celtics.