The Real Holiday Breaks (Bones, That Is)

I am not referring to a "break" from work or school, but rather all of the broken bones that I see the week or so after the holidays. Starting on December 26th, children started limping into my office, or came in favoring their arms - thanks to those new scooters, skateboards, and bicycles. Parents have been good about making kids wear helmets, but it is very difficult to protect those arms and legs from injury; especially when "ramps" are involved.

Children tend to be risk-takers; especially boys. They will happily ride around on the driveway on a new skateboard for about twenty minutes or so; then their male brains start thinking about ramps. In their mind, they see themselves flying through the air, landing safely to the cheers of their friends. Quickly, they find an old milk crate, some fence boards, or a broken piece of plywood, and make a launching ramp. The next sound that you hear is often a broken bone. Yes, sticks and stones do break their bones, but so do many other things.

Winter is also the time for skiing, snowboarding, and ice skating. One bone that is commonly broken with these activities is the coccyx - the tail bone. This is one fracture that does NOT require a cast (thank goodness). We couldn't have people going around in some weird butt cast, but you would be surprised at the number of parents that wonder why I don't cast a coccyx fracture.

We raised five children. Three of them shared seven broken bones (so far). Alex was the first to bite the dust, breaking his left arm when he tripped over a parking lot speed bump. He was a six year old left-hander and thumb-sucker. Hoping to kill two birds with one stone, I elected to put on a full, long arm cast (he only needed a below the elbow cast). The long arm cast prevented him from sucking his thumb! Six weeks later, his arm was healed and he no longer sucked this thumb - a true success story.

At age ten or so, Benjamin was the next to break. He broke BOTH of his arms (like this other child to the left) at school when he tripped on a tree root. Having a cast on both arms creates a hygiene dilemma since it is not possible to wipe your own butt. That boy owes us big time for that extra service. Ben broke his leg in high school football, and just two years ago, he broke his arm again showing off his fancy dance moves at a wedding. There is nothing more impressive to the ladies as breaking your arm while dancing. No, it wasn't break dancing!

Kristin waited until her adult years to break bones. She broke her elbow from falling out of a loft in her apartment, and more recently, broke her clavicle (collar bone) when she fall off her bike. Alcohol may have been involved in this last one.

The other kids were just lucky. Based on their behavior, they should have broken bones, but they somehow escaped. We have three grandchildren now. So far, they have not broken any bones.

The most common fracture that I see in children occurs at the distal radius - the main forearm bone near the thumb side of the wrist. When we fall forward, we instinctually put our arms out in front to protect our face. This sudden force often breaks this bone, either completely through or just cracked/dented. In most cases, this requires a cast.

Kids love casts...for the first few days. Parents are not as enthusiastic. Like scars, a cast is a sign of achievement and a validation that they are tough. Depending on the fracture, upper extremities casts must remain on for four to six weeks. As soon as the kids know that they cannot play soccer or basketball while in a cast, they are very upset. Some parents are even puzzled why they can't play football. Most casts cannot get wet, so showers are other challenges when it comes to bathing and showers. Newer fiberglass casts do not itch like the old plaster casts, but they can still be miserable.

We have casting material in different colors, including glow-in-the-dark. Glow-in-the-dark casts are popular around Halloween. Personally, I would find a lit-up arm quite annoying when trying to sleep, but the kids love them. At Christmas, I make a few striped candy cane casts. If they bring a teddy bear or appropriate doll, I will make sure they get a cast, too.

Like visiting relatives, casts begin to stink after a few days. By the time we remove them six weeks later, you can actually see "stink waves" coming off some of them. I have found a variety of toys, food, and other debris inside casts when I remove them.

Even with all of the parental warnings/guidance and safety equipment, I firmly believe that children can break bones playing with marshmallows. Kids are not only serious risk-takers and clumsy, they like to create their own hazards. Children need to play on monkey bars and climb trees. They need to feel the thrill of a rope swing and that momentary feeling of weightlessness just before they hit the ground. It is not always their fault. Blame it on gravity.

Related Topics:

• 5 Unsafe Things Kids Should Do? Hmmmm...
• WebMD Video: Kids and Broken Bones
• WebMD Video: New Ways to Treat Kids Fractures

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