Sprain Vs Fracture – What’s the difference?

February 3, 2022
child injury, First Aid, fracture, sprain

Sometimes it can be difficult to determine a fracture from a sprain in children as their skeleton is immature and growth plates not fully formed. This makes their bones softer. And since kids may not be able to express what they’re feeling or may not want the outcome to stop them from doing what they love the most, you may be unsure as to whether or not they’ve actually broken something!

Unlike a broken bone with a fracture, a sprain is a soft tissue injury – a stretched or torn muscle or tendon. It can be painful, swollen, bruised and difficult to move, so very hard to tell if broken or not.

However if your child has persistent pain, they stop using a limb completely, they can’t rotate or flex their wrist for example or bear weight on an ankle then it’s more likely that it could be broken.

There’s only really one way to know for sure and that is a trip to A&E or minor injuries unit to carry out an X-Ray or CT Scan so that the treatment your child receives is the right treatment depending on the type of fracture, their age, overall health and medical history.

Treating a Sprain

If you’re sure your child does have a sprain that can be treated at home, remembering RICE – rest, ice, compression and elevation to aid recovery and soothe pain:

A broken bone on the other hand may require complete immobilisation and casting.

Each child is different and you know your child best, so if you are doubting whether or not there is a significant injury its best to get it checked out.

Common fractures in children

If the broken bone punctures the skin, it is called an open or compound fracture. Fractures commonly happen because of car accidents, falls or sports injuries. In children, most fractures occur in the wrist, the forearm and above the elbow.

Here are some common signs to look out for with a fracture:

A snap or grinding noise when the injury occurred
Swelling and bruising
Severe pain, particularly in one spot
Tenderness to the touch
Bent or deformed appearance of the limb
Numbness and tingling
An inability — or unwillingness — to move the limb (Important note: A child may still have a fracture even if she can move the area.)
Child can’t stop mentioning it, getting upset by it because of persistent pain
Child is unable to stand or walk (for instance, in the case of a thighbone or ankle fracture). Return to crawling in a toddler who would be able to walk or cruise.

Other common fractures in a child are the clavicle (collarbone) and the forearm. A collarbone fracture sometimes occurs during childbirth, but can happen anytime a child falls onto their shoulder or an outstretched hand.

A forearm fracture can occur near the wrist, the middle of the forearm or near the elbow. That usually happens when children fall onto their arm or there’s a direct blow to the forearm (like from a ball).

There are several types of fractures that occur in children.

Greenstick fractures occur when the bone breaks only on one side, literally like a green twig on a tree.
Buckle fractures (also called torus fractures) occur when the bone is buckled, twisted and weakened, but not completely fractured.
Bend fractures are a common injury in which the bone is bent but not broken.
Growth-plate fractures affect the special plates at the ends of bones that regulate growth. These breaks are considered more serious — if they don’t heal properly, future development could be affected. For this reason, tots are closely followed for up to 18 months after this kind of break. These fractures can be difficult to detect, so if your doctor suspects this, it will be treated anyway.
Toddler’s fractures, also known as CAST (childhood accidental spiral tibial) fractures, occur when a child twists a foot during a trip, stumble or fall, causing the shinbone to break in a spiral-like pattern. These fractures can also be difficult to detect (there’s no separation in the bone), so if your doctor thinks it’s this type of fracture, he or she will treat it as such.
Complete fractures occur when the bone breaks all the way through.