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

1

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.

2

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.

3

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.

4

Apply cold pack

Place ice or cold pack wrapped in a thin towel over the injury for 20 minutes. This reduces swelling and pain.

5

Manage pain

Give age-appropriate pain relief (ibuprofen or acetaminophen) if the child can swallow safely and surgery is unlikely to be imminent.

6

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.

7

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?
Not always. Call 911 if: Bone is visible through the skin (open/compound fracture)
What should I do first?
Keep the child still and calm — do not move the injured limb. Immobilize the injury in the position found — do not try to straighten the bone. Apply a cold pack wrapped in a cloth to reduce swelling (20 minutes on, 20 off). Call 911 if the bone is protruding, the child cannot move, or there is severe bleeding
What should I NOT 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
How can I prevent this?
Use appropriate safety equipment for sports (helmets, pads, wrist guards). Supervise playground use — ensure equipment is age-appropriate. Install window guards on upper floors

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.