Broken Bone (Fracture) in a Child
Content reviewed against published AAP, OrthoInfo, Red Cross guidelines
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A broken bone (fracture) in a child requires prompt medical evaluation. While most fractures are not life-threatening, proper immobilization and pain management are important to prevent further injury.
Immediate actions
- May not require 911 — see guidance below
- Keep the child still and calm — do not move the injured limb
- DO NOT: Do NOT try to straighten or realign the bone
Step-by-Step Response
Assess the injury
Look for swelling, deformity, bruising, inability to move, or bone visible through the skin. An open (compound) fracture with bone protruding requires 911.
Control any bleeding
If there is an open wound, cover with a clean cloth and apply gentle pressure. Do not push on bone that is sticking out.
Immobilize the injury
Splint the limb in the position found. Use rolled newspapers, towels, or pillows as makeshift splints. Secure gently with tape or cloth strips above and below the injury.
Apply cold pack
Place ice or cold pack wrapped in a thin towel over the injury for 20 minutes. This reduces swelling and pain.
Manage pain
Give age-appropriate pain relief (ibuprofen or acetaminophen) if the child can swallow safely and surgery is unlikely to be imminent.
Transport to ER
For arm injuries, support in a sling. For leg injuries, do not let child bear weight. Drive to ER or call 911 if you cannot safely transport.
Monitor circulation
Check fingers or toes beyond the injury for warmth, color, and feeling. If they become numb, cold, or blue, loosen any wrapping and seek immediate help.
What NOT to Do
- ✕Do NOT try to straighten or realign the bone
- ✕Do NOT move the child unnecessarily if a neck or back injury is possible
- ✕Do NOT apply ice directly to the skin — always wrap in a cloth
- ✕Do NOT give food or drink (in case surgery is needed)
- ✕Do NOT let the child put weight on a suspected leg fracture
- ✕Do NOT remove clothing by pulling over the injury — cut it away if needed
When to Seek Help
Call 911 if:
- Bone is visible through the skin (open/compound fracture)
- Suspected neck, back, or pelvis fracture
- Severe bleeding that will not stop
- Child is unresponsive or in shock (pale, cold, clammy)
- Limb appears severely deformed or angulated
- Fingers or toes are blue, cold, or numb below the injury
Go to ER if:
- Obvious deformity of a limb
- Severe pain and inability to move the limb
- Significant swelling and bruising after a fall or impact
- Child cannot bear weight on leg after injury
- Injury near a joint with loss of range of motion
- Any suspected fracture in a child under 2
Call your doctor if:
- Mild swelling after a fall with pain when touching area
- Child is limping or refusing to use an arm but no obvious deformity
- Toddler is not using one arm after being swung or pulled (possible nursemaid's elbow)
- Follow-up after cast placement if increased pain or swelling occurs
Age-Specific Guidance
0-1 year
Fractures in infants can occur from falls off changing tables or beds. Any fracture in a non-mobile infant without a clear mechanism of injury should raise concern and be evaluated thoroughly.
1-3 years
Toddler fractures of the tibia are common from twisting falls. "Buckle" or "torus" fractures of the wrist are common from falls with outstretched hands. Nursemaid's elbow (pulled elbow) is also frequent.
3-8 years
Playground falls and sports injuries are common causes. The growth plates are the weakest part of the bone and are vulnerable to fracture. Healing is usually faster in children than adults.
Prevention
- Use appropriate safety equipment for sports (helmets, pads, wrist guards)
- Supervise playground use — ensure equipment is age-appropriate
- Install window guards on upper floors
- Use gates at the top and bottom of stairs for toddlers
- Ensure adequate calcium and vitamin D for bone health
- Teach children safe falling techniques in sports
- Keep furniture stable — anchor bookshelves and dressers to walls
Frequently asked questions
Should I call 911 for broken bone (fracture) in a child?
What should I do first?
What should I NOT do?
How can I prevent this?
Sources
All content follows our editorial policy and is reviewed against published clinical guidelines.
2,705 evidence-based guides6 authoritative medical sources
Related Emergency Guides
Bottom line
Stay calm and follow the steps above. When in doubt, call your pediatrician or go to the nearest emergency room.
You are doing the right thing by learning what to do in an emergency. Being prepared is one of the best things you can do for your child.