Information page · Paediatric orthopaedics
Paediatric injuries and fractures
General information and guidance after an ER visit, X-rays, casting or sports trauma in children and adolescents.
In children, fractures should be interpreted considering age, lesion site, growth plate and remodelling potential. This page provides general guidance and does not replace a medical evaluation.
This page is for informational purposes and does not replace the ER or a medical visit. In case of visible deformity, severe uncontrolled pain, cold or pale fingers, sensory changes, open wounds or major trauma, urgent ER care is required.
Where to start
Already had an ER visit or X-rays
When a paediatric orthopaedic follow-up can be useful after the first assessment.
Go to sectionWhen to return to the ER
Signs that require a new urgent evaluation after a trauma.
Go to sectionMost common fractures
A general overview by anatomical area, for informational purposes only.
Go to sectionRecovery and return to sport
General information about returning to activities after a trauma.
Go to sectionWhen a paediatric orthopaedic check-up may be useful after the ER
After a trauma, the ER is there to rule out or treat urgent conditions. In some cases a subsequent paediatric orthopaedic evaluation can be useful to clarify the picture, monitor evolution, assess the relationship with the growth plate and plan any follow-ups.
- fracture close to the growth plate
- doubts about the report or X-rays
- persistent pain or swelling
- cast or brace to be monitored
- sports trauma with difficulty resuming activity
- need for personalised guidance on school, sport and daily activities
What to bring to the visit
- X-rays or images taken in the ER
- radiology report
- ER discharge note
- instructions received about cast, brace or weight-bearing
- any previous follow-ups
- information about the mechanism of injury
- sport practised and return-to-play goals
Bringing the available documentation helps to reconstruct the pathway already followed and makes the evaluation more complete.
🩺Clinical note by Dr. Priano
When evaluating a paediatric fracture, it is not only about establishing whether the bone is broken: lesion site, relationship with the growth plate, the child's age, remodelling potential and the most appropriate follow-up pathway all matter.
Explore by fracture location
The information here is general: management depends on age, lesion site, fracture type, symptoms, X-rays and clinical evaluation.
Leg fractures in children
Tibia, fibula and both-bone leg fractures: why alignment and axis control matter.
Learn moreForearm fractures in children
Radius, ulna, both-bone and Monteggia-type injuries: why rotation and alignment matter.
Learn moreClavicle fracture in children
Common after falls or sport, with different evaluation in younger children and adolescents.
Learn moreHumerus fractures in children
Proximal, shaft and distal humerus: different sites, different risks, different follow-up.
Learn moreFemur fracture in children
Less frequent but important injuries, to be evaluated carefully by age and fracture type.
Learn moreElbow fractures in children
Supracondylar, medial epicondyle, lateral condyle, radial head and nursemaid's elbow.
Learn moreWrist fractures in children
Distal radius, growth plate and remodelling: the role of age and displacement.
Learn moreKnee trauma in children and adolescents
Tibial spine avulsions, osteochondral lesions, osteochondritis dissecans and sports trauma.
Learn moreIndividual pages are not meant to decide treatment on your own, but to clarify which aspects are considered during a paediatric orthopaedic visit.
Fractures and the growth plate
An important part of paediatric traumatology concerns lesions close to the growth plates. In these cases the evaluation is not only about the fracture itself but also about the lesion site, the child's age, remodelling potential and any need for follow-up over time.
Read about growth plate separationsSports trauma and return to activity
In children and adolescents, the return to sport should be evaluated case by case. Pain, mobility, strength, bone healing, type of sport and risk of new trauma are all elements that can influence the pathway.
Read about sports traumaFrequently asked questions
Is a paediatric orthopaedic check-up always necessary after a fracture?+
Not always. It can be useful when the fracture is near the growth plate, when there are doubts about the report, or when personalised guidance is needed on follow-ups, recovery and activities.
Can a child play sport while in a cast?+
It depends on the case and on the indications received. In general, activities involving a risk of falling or new trauma should be considered with caution and discussed with the doctor.
Do children's fractures straighten on their own?+
Some deformities can remodel with growth, but not all of them. It depends on the child's age, fracture site, type of deformity and growth plate involvement.
When should I be worried after a trauma?+
Visible deformity, severe uncontrolled pain, cold or pale fingers, sensory changes, open wounds or major trauma require urgent evaluation in the ER.
What is needed to understand whether the pathway is correct?+
Clinical examination, X-rays, the child's age, fracture site, symptoms and documentation of the pathway already followed are all needed. A single report may not be enough to clarify everything.
Paediatric orthopaedic check-up after trauma or fracture
Dr. Daniele Priano sees children and adolescents in Milan. The evaluation can be useful after an ER visit, X-rays, casting, sports trauma or doubts about the follow-up pathway.
Disclaimer: content for general informational purposes only. It does not replace a medical evaluation.