9mo with broken tibia. Any experience of this?

[HolidaysQueen]

I fell last Friday on the stairs, not badly, but DS (9mo) was on my hip and his leg got caught between me and the stairs. He was upset for a while but fine after about 30 mins and no sign of injury, but then over the weekend we noticed he was no longer putting weight on his leg (had just started to stand very well) although not seeming in pain. Took him to GP Mon am who referred to orthopaedic consultant and today we found out that he has broken his tibia in 2 or possibly 3 places

No cast because he isn't walking so she says there is no point as it would just get in the way of washing and dressing and he doesn't really need the support as he isn't mobile. Wants to check again in 1 month and then if healed okay check again in 6 months to make sure it hasn't affected his growth. The worst break is up near the top of the bone where apparently there can be some problems later.

Anyone had any experience of this with a baby? I'm just trying to understand if this laissez-faire approach is the normal course of action, what if anything we can do to aid his recovery, what we should be looking out for, and what the likely problems could be long term with his walking etc.

Thanks.

Poor you I always worry about something like this happening to my dd, can't imagine how you feel. I suppose they are probably going down this route as baby's have soft bones and tend to heal quickly. I'm sure if they are worried they would have done more. I suppose the best thing you can do is make sure he has a healthy diet and possibly see your gp about any vitamins/supplements that can aid healing. Good luck, i hope he is ok soon

Poor you I always worry about something like this happening to my dd, can't imagine how you feel. I suppose they are probably going down this route as baby's have soft bones and tend to heal quickly. I'm sure if they are worried they would have done more. I suppose the best thing you can do is make sure he has a healthy diet and possibly see your gp about any vitamins/supplements that can aid healing. Good luck, i hope he is ok soon

Sorry, didn't mean to post twice, computer playing silly buggers

bump

Not the best person on here I suspect as I mostly deal with adults.

If a person isn't weight bearing the bone is not stressed, and is unlikely to move. Healing occurs at the broken ends, and they grow out to each other. The ends do not have to be exactly in line with each other because when you break a bone it sort of "overgrows" to form a lumpy callus, and it is then remodelled to a straight bone over a longer period of time.

A cast is probably superfluous, and would seriously hamper your daily care of your son. It sounds like a sensible decision to me for your son. But if your DS starts to move about/pull up in the time you've been told you will have to contact the department again and perhaps reconsider.

The bedbound elderly, or those with spinal injuries that require bed rest are also not necessarily casted for some breaks. Fingers unless a particular spiral fracture are only splinted to relieve pain. So a cast is not essential with a broken bone.

The break near the top of the bone is the one to worry about re growth. There are growth plates at either end of the long bones in the body. If a break goes through that (and it is difficult to see on x ray exactly where the growth plate is next to the fracture) it can interfere with the rate of normal growth of that end of the bone. Which can lead to leg length discrepancy.

They may not do anything about that initially other than watch and wait, as lots of people have one leg slightly longer than the other. What you might see if it is a discrepancy - your son will limp, or seem to walk with a waddle as a hip drops to compensate in the step for the short leg.

Does any of that help?

I don't have experience of broken legs in that age, but do have experience of casts on little ones. My son had talipes (club foot) and had his first op at about 10 months. He was in a full leg cast for 6 weeks I think. We had other casts before that but only for 10 days at a time)

It is a pain in the arse, especially with a child of nappy wearing age, but if you do end up having to get a cast it is do-able. He crawled around with it on, and coasted too.

I have met one other little boy (when in Alder Hey for subsequent Ops) that had the problem with an old break effecting his leg growth. They were sorting it out with one of those external frames. He was the happiest, cheekiest boy, and just referred to it as the ultimate in extreme body-piercing.

rempy, thank you that really helps explain the things that i was wondering about - as ever it's one of those things where all the questions come into your mind about half an hour after you've left the doctor's office!

is there anything i can do to aid recovery or do i just let him get on with it? i will keep an eye out for increased movement or pulling up etc. i'm going to avoid his gymboree class as aimed at getting them to pull up, stand etc., but was going to take him swimming instead as he loves that. i assume that would be fine as no weight bearing involved.

Wasnt going to mention external fixation!

But yes, if there is a persistent problematic leg length discrepancy, what they do now is once the child is an appropriate age (this is all related to growth, and convenience for the family as it is a long course of treatment) they can lengthen legs by deliberately breaking the bone, applying an external frame that pins both bits of the bone, and pull them apart gradually to make it longer.

It sounds totally barbaric. It looks very impressive and high tech, like a giant mechano set. It is not actually painful every day, but on days where the bones are moved it is painful. It can take a couple of years of treatment. Several operations.

On the whole kids and families get on well with it. They become regulars on the specialist ward that deals with it, and get into the routine of it all. Because of the length of treatment there is often very good play specialist or psychological support to keep your child going and happy in hospital, and efforts to keep up with school work etc are made.

Please do not imagine that this is what is going to happen to your son. In all probability he will need no further treatment at all. And in between doing nothing, and ex fix, are several other options. It is not possible to second guess what will happen now.

Deffo swimming, very good idea. Yes, avoid lots of encouragement to stand, but if in a few weeks he seems happy to do it, let him.

Nothing can aid recovery of the bone, he will be drinking lots of milk anyway I guess, so will be getting lots and lots of calcium.

Because they are growing so quickly anyway, he will heal quickly. Little ones are primed to grow and recover.

ah, i work for a pharma company and am unnaturally interested in the ins and outs of medical treatments, and always want to know worst case, so happy to hear about external fixation

right, swimming it is. off on hols soon so he'll be getting daily swimming practice in the pool soon enough anyway

i love the fact that there is always someone on mumsnet who knows (rempy) or has personal experience (benny) or is just there to sympathise (alice). thank you all.

Yes sorry - I realised after hitting send that external fixation might sound rather scary

I meant to say that I hope his break doesn't effect him in that way, but if it does it is fixable

I think I should go and put my head down for an hour