Trauma & Acute Injuries in Children

Pediatric trauma is part of growing up. Kids climb, jump, race, and test their limits, and sooner or later many of them come home with an arm they will not move or a swollen ankle. Research from Sweden, still widely cited in pediatric orthopedics, found that roughly 42 to 64 percent of boys and 27 to 40 percent of girls break at least one bone before age 16. Those numbers do not include the dislocations, finger crush injuries, and sprains that also send families looking for answers.

Our pediatric orthopedic team in Gilbert treats sudden injuries in children of every age, from a toddler’s first tumble to a teenager’s bike crash. This page explains why injured kids need a different approach than adults, the everyday accidents that cause them, how to decide between the emergency room and a specialist visit, the injuries we see most by body area, and what recovery looks like at home.

How Children’s Injuries Differ From Adult Injuries

A child’s bone is more flexible and has a thicker outer covering, called the periosteum, than an adult’s. Instead of snapping cleanly, a young bone often bends, buckles, or cracks on only one side. That flexibility creates injury patterns that rarely happen in adults:

• Buckle fractures, also called torus fractures, where the bone compresses and bulges slightly, most often just above the wrist.
• Greenstick fractures, where the bone bends and cracks on one side, much like a fresh twig.
• Plastic deformation, where a bone bends without a visible break on an X-ray, most often in the forearm.
• Growth plate fractures, which pass through the developing cartilage near the end of a bone. Our growth plate injuries page explains these in depth.

Children also heal faster and can remodel. A young bone that heals with a slight angle can gradually straighten itself as it grows, which means some fractures that would need surgery in an adult can be treated with a cast in a child. Knowing how much remodeling to expect at a given age and location is one of the main reasons injured children benefit from a pediatric specialist.

At the same time, some childhood injuries are easy to miss. Young children may not be able to say where it hurts, and certain injuries, such as a nondisplaced elbow fracture or a toddler’s shin fracture, can look normal on a first X-ray. Careful examination and, when needed, repeat imaging make a real difference.

How a child shows pain also changes with age. Infants may simply be fussy and cry when a limb is moved during a diaper change. Toddlers often stop using an arm or refuse to walk rather than pointing to a sore spot. School-age children can usually show where it hurts but may hide an injury to avoid missing recess or a playdate. Teens tend to describe symptoms clearly but may downplay them. Paying attention to what your child stops doing is often more telling than what they say.

Everyday Accidents That Cause Acute Injuries

Most childhood trauma does not come from organized sports. It comes from ordinary play, around the house and the neighborhood.

Falls

Falls are the leading cause of broken bones in children. A fall onto an outstretched hand from monkey bars, a bunk bed, a couch, or simply while running is the classic way kids break a wrist, forearm, or elbow. Falls from heights, such as a tree, a second-story window, or a balcony, can cause more serious injuries to the arms, legs, or spine.

Trampolines

Backyard trampolines are common across the East Valley, and they cause a steady stream of injuries that come in our office. Most happen when more than one child jumps at once, because the lighter child is thrown unpredictably and lands awkwardly. Fractures of the elbow, forearm, ankle, and lower leg are typical, along with neck injuries from flips. For this reason, the American Academy of Pediatrics discourages home trampoline use. Our trampoline injuries page covers safety rules for families who choose to keep one.

Playgrounds

According to the CDC, emergency departments treat more than 200,000 children ages 14 and younger for playground-related injuries each year. Climbing equipment, slides, and swings account for most of them, and hard surfaces such as packed dirt, concrete, or worn-out mulch increase the risk of injury. Our playground injuries page explains what to look for in a safe play surface.

Bikes, Scooters, Skateboards, and Other Wheels

Wheeled activities combine speed with hard pavement. Wrist and forearm fractures are especially common in skateboarding and scooter riding, while bike crashes can injure the collarbone, elbow, and lower leg. Electric scooters and e-bikes add speed and raise the risk of more severe injuries.

Injuries at Home

Fingers caught in car doors, house doors, and folding furniture often cause fingertip fractures and nail bed injuries. Toddlers can fracture a shinbone simply by twisting while they walk or trip. A quick pull on a young child’s arm, such as lifting them by the hand or catching them during a fall, can cause a nursemaid’s elbow.

Car Crashes and High-Energy Injuries

Motor vehicle crashes, ATV accidents, and falls from significant heights can cause thighbone fractures, pelvic injuries, and multiple injuries at once. These children are first cared for by emergency and trauma teams, and our role often begins with fracture management and follow-up once the child is stable.

Emergency Room or Specialist Visit?

Knowing where to go first saves time and stress. The chart below gives general guidance.

Go to the emergency room or call 911 for a bone that has broken through the skin, an obvious bend or deformity, persistent numbness or tingling, a hand or foot that is cold, pale, or blue, severe pain that does not ease with rest and over-the-counter pain medicine, or any head, neck, or back injuries. These signs can mean a serious fracture or damage to nerves or blood vessels.

For injuries without these signs, a prompt visit with a pediatric orthopedic specialist is often the better first stop. Until the visit, keep the injured area still with a soft splint or sling, apply ice wrapped in a cloth for 15 to 20 minutes at a time, and keep the limb raised to help with swelling and pain. Do not let your child continue playing on an injured arm or leg.

If your child has already been seen in an emergency room or urgent care, the discharge papers usually say to follow up with orthopedics within a few days. That follow-up visit matters. Emergency splints are temporary, and early specialist review confirms the diagnosis, checks alignment, and starts definitive treatment while the bone is still easy to guide into position.

Common Acute Injuries by Body Area

The injuries below are the ones we treat most often. Each has its own page with more detail on symptoms, treatment, and healing.

Wrist and Forearm

The wrist and forearm are the most frequently broken areas in children. Buckle fractures are stable injuries that often heal in a removable splint or short cast and sometimes need repeat X-rays. Greenstick fractures of the forearm sometimes need the bone gently straightened before casting so it heals in a good position. Less often, a forearm fracture is paired with an elbow dislocation, called a Monteggia fracture, which needs careful attention because the elbow injury is easy to overlook. Our pages on buckle fractures, greenstick fractures, and Monteggia fractures explain each one.

Elbow

Nursemaid’s elbow is a partial slip of one of the elbow bones, most common between ages 1 and 4. It usually happens when a young child’s arm is pulled, and the child suddenly refuses to use the arm, holding it slightly bent by the side. A trained provider can usually correct it in seconds with a gentle maneuver, and most children start using the arm again within minutes. Our nursemaid’s elbow page explains how to tell it apart from a fracture and how to lower the risk of it happening again.

Supracondylar fractures are breaks just above the elbow and are the most common elbow fracture in children, typically between ages 5 and 7. They usually happen from a fall on playground equipment or a trampoline. Because the area contains important nerves and blood vessels, these fractures need prompt evaluation. Minor ones are treated in a cast, while displaced fractures often need the bones repositioned and held with pins. Our supracondylar fracture page walks families through both paths.

Collarbone

The collarbone, or clavicle, is one of the most commonly broken bones in childhood. It can break during birth, in a fall onto the shoulder, or in a bike crash. Most collarbone fractures in children heal well in a sling, and a firm bump often forms at the healing site that gradually smooths out over months. Our collarbone fracture page explains when surgery is considered in older teens.

Hand and Fingers

A jammed finger happens when the tip of a finger takes a direct hit, such as from a ball or a door. Many are minor sprains, but some involve a small fracture or a torn tendon that can leave the finger stiff or bent if not treated correctly. Finger fractures, fingertip crush injuries, and injuries near the knuckles are also common. Our jammed finger page explains when a finger needs an X-ray and a splint.

Lower Leg and Ankle

A toddler’s fracture is a thin spiral crack in the shinbone of a child between roughly 9 months and 3 years old, often from a simple twist or trip. The usual sign is a toddler who suddenly limps or refuses to walk, sometimes without any fall that a parent noticed. The fracture may not appear on the first X-ray. Our toddler’s fracture page covers how it is diagnosed and treated.

Ankle injuries are common at every age. In children, what looks like a sprained ankle may involve the growth plate at the end of the lower leg bones, so a painful, swollen ankle that a child will not walk on deserves an exam rather than a guess. Our ankle injuries page explains the difference.

We were very pleased with the care our child received. The team was calm, professional, and made a difficult situation much easier

Compassionate care during a stressful moment

After a long recovery elsewhere, we came here for another perspective. The provider offered a straightforward, helpful plan that finally moved our child forward

A second opinion that made all the difference

Our experience was excellent. The staff was attentive and made sure our child received the best care possible. We left feeling supported and informed.

We’re grateful for the thoughtful, professional approach

We felt confident in the treatment plan and appreciated how clearly everything was explained. The follow‑up care was just as thorough and reassuring.

Exceptional care and clear communication

The team made us feel supported from the moment we arrived. They were kind, patient, and focused on making sure our child felt comfortable throughout

They truly put children first

Had a visit for my 7 year old pitcher. He’s been complaining about his elbow. Everything about this visit was amazing. Every single staff member

Suzy Wade

Thighbone, Dislocations, and Other Serious Injuries

Thighbone fractures are less common but significant injuries, and treatment depends heavily on the child’s age, from a special cast in infants to internal fixation in older children. Kneecap and shoulder dislocations need prompt evaluation to check for related fractures and to reduce the risk of the joint slipping again.

Ages and urgency are general guidance. Emergency signs always mean the ER first. Sources: AAOS OrthoInfo and POSNA OrthoKids.

One of the most common surprises for parents is how quickly children heal. Many common childhood fractures need only three to six weeks of protection, compared with longer periods for similar injuries in adults. Your child’s timeline depends on the exact injury, age, and how well the bone is aligned, and we confirm healing before clearing for sports and activities.

How Acute Injuries Are Treated

We match treatment to the injury, the child’s age, and how much healing and remodeling we can expect. In broad terms, options include:

• Splints, slings, and buddy taping for stable injuries such as buckle fractures, many finger injuries, and collarbone fractures.
• Casts and walking boots to hold a fracture still while it heals.
• Closed reduction, where a shifted bone is moved back into position without an incision, followed by a cast.
• Surgical fixation with pins, wires, plates, or rods for fractures that cannot be held in a good position any other way.

Our fracture care page explains each treatment in detail, including how we decide between them.

Caring for an Injury at Home

Recovery happens mostly at home, and a few habits make it smoother:

• Keep the cast or splint dry unless you have been given a waterproof cast. In the Arizona heat, sweat can build up inside a cast, so keep your child cool and limit time outside on the hottest afternoons.
• Do not put anything inside the cast to scratch an itch. A hair dryer on the cool setting blown into the cast edge can help.
• Keep the limb raised for the first two to three days to reduce swelling and pain.
• Check fingers and toes for color, warmth, and movement, especially in the first few days.
• Follow the activity plan. No trampolines, climbing, or wheels until we say it is safe, even if your child feels fine.

Call us right away if pain increases instead of improving, fingers or toes become numb, pale, or swollen, the cast becomes wet, cracked, or loose, or you notice a bad smell or drainage from inside the cast.

Healing, Follow-Up, and Getting Back to Play

Most acute injuries need one or more follow-up visits to confirm the bone is healing in a good position. Some fractures are rechecked with X-rays at one to two weeks, when small shifts can still be corrected easily. Once the cast comes off, the joint is often stiff, and the skin may be dry or flaky, and both improve over a few weeks of normal use. Many children regain motion on their own through play, while some benefit from brief therapy. We clear children to return to full activity once the bone has healed and strength and motion are back to normal, and we let you know if any injury, such as one involving the growth plate, needs longer-term monitoring.

Lowering the Risk of Childhood Injuries

Accidents will always happen, but a few steps prevent many of the injuries we treat:

• Allow only one jumper at a time on a trampoline, with no flips, and keep netting and pads in good repair.
• Choose playgrounds with deep, soft surfaces such as rubber, wood chips, or sand, and keep young children on age-appropriate equipment.
• Use helmets for every bike, scooter, and skateboard ride, and add wrist guards for skateboarding and in-line skating.
• Install window guards or stops on upper-floor windows and keep furniture away from windows.
• Lift young children under the arms rather than by the hands or wrists.
• Use a correctly sized car seat or booster seat for your child’s age and size on every trip.

Frequently Asked Questions About Acute Injuries in Children