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Fall Injuries

By Bjarne Lühr Hansen PhD, MD and Philipp Skafte-Holm MD, Mentor Institute

Especially in the spring, many children are injured. It may be the in the playground, cycling or at sporting activities. Children are very active and will therefore often get injuries. Meanwhile, play and sport is important for the child's physical and social development. Here the child learns to use his/her body and to deal with friends.

Accidents when cycling has become more and more common. When a child bikes - often by 20 km / h - and hits a car, it may cause serious damage. Children's heads weigh much compared to the rest of the body, and therefore they fall upside down. Since it unfortunately also is common for kids to ride bikes without helmets, there are many serious accidents on the bike.

Most people know a child who very often gets into trouble - the so-called "accident birds". It is true that there are special "unfortunate" children, often injured, but they are thankfully rare. All children can get in an accident. This is because children's vision, hearing and perception of speed and assessment of distances have not developed before they reach school age. Knowledge of children’s development has led to the following rules of thumb:

• Children are ready to ride bikes when they are 5 years old
• Children are ready to cross a street with traffic when they are 9 years old
• Children can ride a bike in traffic when they are 11-12 years old

When the child falls and hurts itself the parents are often worried that the child has fractured a bone or injured a joint. Children have very strong joints and ligament whilst their bones are less strong. It means e.g. that a twist of the ankle will with adults lead to a sprained ankle and with children, this could lead to a broken bone. A broken bone is therefore more common with children than with adults.

If the child can move normally after a fall or a blow and plays as usual, there has occurred no serious damage. If the child on the other hand does not want to use the arm or will not lean on the leg, you should suspect a fracture or a sprain.

A fracture typically shows with immediate pain when the bone is moved (e.g., when the child lean on the leg or moves the arm). The most common fractures with children is in the forearm down by the wrist, in the lower leg down by the ankle joint and by the elbow. When you get a bone fracture, you get immediate pain, swelling and ache. Typically, the child will not lean on the leg or use the arm due to pain. If you press the bone, severe pain occurs.

A sprain shows when the child immediately after the accident cannot move the joint without pain. This is how you can distinguish between a bone fracture and sprain of a joint. After a couple of hours, the joint swells and there will be pain. The most common sprained joints are foot, hand and finger joint.

Another common injury with children is overload that can occur when you repeat some movements. No matter which sport the child practice there will always be a risk of overload. The most common overload injuries are in the knee and foot joint. Typically, the child complains about pain sometime after the movement has started and after a break for a couple of days, the pain disappears.

Muscle injuries are common among the older children. A so-called pulled muscle occurs when some of the threads in the muscle bursts. An accumulation of blood occurs around the pulled muscle. The accumulation of blood appears around the pulled muscle. The accumulation of blood appears as swelling and soreness. The child complains about pain when moving the muscle. Pulled muscles in shank, thigh and shoulder-muscles can occur when the child plays football or handball.

Click here to read about how you evaluate your child

What can you do?

Cooling, tight bandage, rest and lifting the injured body part are the most important forms of treatment – weather it is a fracture, sprain or a pulled muscle.

Cool the place where the injury is with cooling-bags or ice cubes for at least 30 minutes. Put a tight bandage around the injured place and let it stay on for a couple of days until the soreness is gone. Remove the tight bandage during the night when the child is sleeping. The injured child should rest for 1 - 2 days without straining the injured area. Remove the bedding and put up the injured leg or arm to 45 degrees for a couple of hours. You might need painkillers. Remember that children under the age of 2 years cannot have painkillers without the doctor’s instructions.

Contact the doctor tomorrow

If there still is heavy swelling and pain.

Contact the doctor immediately

If the child is still in pain in spite of your own treatment. If you suspect that there is a fracture on the bone.