First and foremost - do not panic! Anxiety of loved ones, fear, insecurity, impotence before the deceased oppress the child, neuroticize it. The recovery process for bone fractures is always long, so be patient, calm yourself, calm the child and listen carefully to the doctor's advice.
Statistics say that in 10% of cases a femoral bone fracture occurs, up to 40% is fractures of the bones of the lower leg, the rest - fractures of the bones of the foot and fingers. Fractures of the ankles in children are extremely rare. Most often, the bones of the lower limbs break when falling or jumping from a height. Fractures of the foot and toes occur with a direct stroke, the fall of weights on the foot. Most often this is a street or sports injury.
If after the imposition of a cast bandage or a tire (often called a longtail), the child is released home, this is already good. Apparently, a fracture without bias and it can be treated in a polyclinic. If the doctor offers to stay for a few days in the hospital, listen. The hospital will provide more professional care and from the first days will begin treatment and rehabilitation activities.
If treatment is done at home
During the first day, the gypsum dressing is gradually dried. At this time it is fragile and can break. A damaged leg should be given an elevated position - lay on a pillow or a blanket folded in several layers, the foot should be just above the level of the knee joint. Cover wet gypsum bandage should not be, and to accelerate its drying, you can use the radiant heat from the table lamp.
Any presence of children's fractures is accompanied by local circulatory disorders, which are manifested by swelling, skin discoloration, a violation of skin sensitivity. The more significant the injury, the more pronounced the swelling. Traumatic edema compresses tissues, compacts them and is a natural protective reaction that protects bone fragments from divergence and displacement. But, squeezing the vessels, edema prevents the blood flow to the fragments, slowing their fusion. Therefore, an elevated limb position is recommended, early finger movements of the injured leg.
By the end of the first week, edema, as a rule, significantly decreases, the skin on the foot acquires a normal color, wrinkles. Following a declining edema, a secondary bias in the plaster bandage may occur. Therefore, for certain types of fractures on the 4-5th day, the doctor recommends a control X-ray study. By the end of the first week, all the unpleasant sensations under the bandage should disappear.
Correctly imposed plaster bandage tightly covers the limb, does not press, gives a sense of reliability and security. At this time, you can start rehabilitation - to teach the child walking with crutches. Children quickly learn this "science", we often see in the hospital, as they run with crutches race.
Do not review the complications
Prolonged or persistent swelling, bluish tinge of the subungual lobes, blanching and decrease in the temperature of the toes, sensitivity disorders in the form of "numbness" or "crawling crawling" signal gross abnormalities of the local circulation and are the basis for immediate medical attention.
It is impossible to ignore the long-lasting pains outside the fracture site. This is due to the pressure of the cast bandage on poorly protected or insufficiently modeled bone protrusions and can lead to the formation of pressure sores. At the next visit to the doctor, tell him about it.
Very often under the dressing there is a skin itch. He can be pronounced, debilitating, interferes with sleep, which also needs to be told to the doctor. If this is possible and will not cause complications, then the plaster bandage will be removed, the hygiene of the skin will be effected, it will be processed and the gypsum again applied. It is not necessary to perform such manipulation on your own.
Over time, the cast plaster "grows old," becomes fragile, cracks, crumbles and breaks. The inevitable muscle hypotrophy - "shrinkage" with long periods of treatment - leads to the fact that the dressing becomes loose, no longer fulfills its functions and must be replaced.
The terms of rehabilitation after children's fractures and the timing of bone splices depend on the child's age, size, bone mass, its functional and anatomical features and the nature of the fracture. The larger the bone and the older the child, the more time it will take. If the phalanges of the toes grow together in 2-3 weeks, it may take 2-3 and up to 4-5 months for fracture of the tibia after some fractures of the femur.
Begin workouts
In the last weeks of wearing a plaster bandage, a doctor can recommend walking with a dosed load and under the supervision of the parents. This is a very important detail, allowing to assess the quality of fracture fusion. If a child walks around and runs around in a plaster bandage, there is no swelling and pain, then there is no need for this bandage anymore. Dosage load is increased gradually: first the child slightly starts on the damaged leg using crutches, then leaves one crutch, then the cane is used, and finally, it is allowed full load. Walking in a cast bandage normalizes muscle tone, improves the vascular walls, promotes the functional reorganization of bone fusion.
Some moving and excitable children may have a fear of removing the plaster bandage, this is due to the addiction to it and the violation of deep types of sensitivity: the leg is perceived as "not its own." This phenomenon takes place in 2-4 days. At this time, the leg can be tightly bandaged.
Before removing the gypsum, a control radiography is assigned. Do not worry if after that the doctor decides to continue treatment in a plaster bandage - the fusion must be reliable! Some children start walking earlier than they are allowed to. Usually nothing terrible happens. The girl of three years received an oblique fracture of the tibia when she fell from the porch. For two weeks my leg was in plaster. All this time my father wore a child in his arms. In the third week, my parents sat in the kitchen, and the baby got off the bed and came to them ... Can you imagine the state of your parents? After examining the child, nothing threatening was found, walking in a plaster bandage was allowed, and after 10 days the plaster cast was finally taken off.
Now - for rehabilitation!
With the removal of the plaster bandage treatment does not end, but goes into its final phase: restoration of function and rehabilitation after fracture. You need to start with exercise therapy in combination with massage and physiotherapy. It is very important to convince the child to engage in physical therapy independently: the training complex of exercises is performed in the polyclinic under the guidance of the instructor and at least twice a day repeats the houses on their own.
In the long-term period with fractures of long tubular bones, we observe a long-lasting muscle malnutrition, which is manifested by a decrease in muscle mass. This is the result of trauma and prolonged immobilization. Perhaps some lag in the growth of the injured limb, which does not exceed usually 1.5-2 cm and is not reflected on the gait.
Rarely is the elongation of the fractured limb as a result of local restructuring and revitalization of metabolic processes aimed at an early fusion. Particular attention is required for periarticular and intraarticular fractures, the recovery treatment for these lesions has its own peculiarities.
Given such a variety of outcomes and long-term results of treatment of crural fractures of the lower leg and thigh, children with similar injuries are subject to follow-up at the orthopedic trauma clinic in the district clinic for at least a year.
The psychic also suffers
Psychologically, the trauma of the lower limb is more difficult to tolerate than the hand injury. The motor activity sharply decreases, the vital space narrows, and some social isolation is formed. Therefore, from the first days it is necessary to work out a new regime of the day, to provide adequate care for the child. We should try to maintain a cheerful mood, saturate every day with positive emotions, resolve meetings with friends, classmates. Very useful examples from life and literature, reinforcing the belief in a speedy recovery, forming resilience, tolerance and courage.
Of great importance is the diet, the diet of the child should include products containing calcium, phosphorus salts, digestible proteins, vitamins. Recommended poultry meat, veal, fresh fish, vegetables, fruits, dairy products. It is necessary to adjust the stool, since a forced position in the plaster bandage can cause problems with the intestine. Only calm and confident behavior of parents, rational nutrition, strict implementation of all medical recommendations will help the child to cope with the trauma more quickly, and the family - to survive the raging disaster.