Kids with broken bones

[jen42]

I've been an elementary school nurse for two months now, and we've had 5 broken bones. (Damn you, monkey bars!!) I've dealt with broken bones in adults, where people scream, cry, or talk incessantly, and it seems to be that the kids are acting very differently. Every child has gotten very quiet, even the younger ones, very pale. Sometimes they shake, sometimes they don't. They may get teary-eyed, but none of them have been actually crying. They're usually able to talk softly, and even interact with their friends, although they seem subdued.

None of these have been compound fractures, and it's been mostly arms. I'm wondering, do kids normally react to broken bones this way? Besides swelling and obvious deformities, what more can I look for so I don't miss one? I nearly missed a broken elbow a couple of weeks back.

[Jolie, BSN]

You raise an interesting point! Now that I think of it, all of the broken bones amonsgt my girls and our neighbor children have gone awhile without being diagnosed, largely because of the relatively minor reactions of the break-ees.

My neighbor's daughter broke her wrist, and she realized it the next night when the little girl started to run a low-grade temp. My neighbor is an X-ray tech, and she says that she hears this kind of story all the time. She attributes the elevated temp to the inflammatory response to the fracture.

My daughter's broken collarbone went un-noticed until the next morning when she started to complain of significant pain. It hadn't hurt much when she fell, and I couldn't feel any bone fragments, so I didn't think she was seriously hurt.

Another neighbor girl broke her elbow in a fall from the swing set, and continued to play for some time before complaining of pain. This was the second time she had broken her elbow, and she didn't realize that there was anything wrong until she was unable to take her shirt off at bath time.

I guess kids are just more resilient. I would be crying out for pain medicine!