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Original poster

Is this normal for A&E?

23 replies

KitKat1985 · 09/11/2019 21:04

DD2 (3) had a fall down some steps this afternoon. Afterwards she hasn't been able to put any weight on her right foot, and literally screams or sobs if you try to stand her or try to get her to walk (very unlike her), but is otherwise okay in herself when just sat down etc. There's no obvious bruising or swelling to her right foot or leg. We (me and DH) took her to A&E they examined her and tried to get her to stand / walk (she couldn't at all) but then said they wouldn't x-ray her as there was no obvious site for a break as wasn't flinching etc anywhere on her leg / foot when touched, and they don't like exposing young children to x-rays. Is this normal? They've advised it's probably a bad sprain and to give regular calpol, but to "have a low threshold to bring her back if she's not walking on it in a day or two". I just found it weird they wouldn't x-ray her when she literally isn't standing or walking on her right foot at all. Obviously I don't want her to have unnecessary x-rays either but I don't want a fracture or something to be missed either.

OP posts:

Maidestone · 09/11/2019 21:09

That sounds pretty normal to me. And as they've said, if she's still not able to stand on it in 48 hours then take her back and I'm sure they'll X-ray then.

You might as well try and avoid an x-ray if you can. They've used their medical experience and don't think it's fractured.

Maidestone · 09/11/2019 21:10

And I think if she'd fractured it she'd be in pain constantly - she wouldn't be "okay in herself" when sat down.

It sounds more like a nasty sprain to me.

edgehorn · 09/11/2019 21:10

It could be a hairline fracture which in some instances requires a cast. I'd be asking for an xray to rule it out.

ViaSacra · 09/11/2019 21:13

Give it a couple of days. If she's still in a lot of pain then, then take her back.

Even if it is fractured, it's unlikely to be a very serious break, so a few days' delay in getting a cast on it won't affect the healing outcome. It's best to avoid an X-ray at such a young age if you possibly can.

RightEarlobeBreath · 09/11/2019 21:13

I'd be taking her back ASAP. Our DS broke his leg and they we had to push for an x ray because they didn't think there was a break as he was calm unless he had to try and bear weight. There was no bruising and no swelling. The only sign was his crying and screaming if we tried to make him stand or when we had to move his leg to do his nappy. Proper screams of pain that I've not heard him make with any other injury.

Original poster

KitKat1985 · 09/11/2019 21:16

Okay, well we will follow their advice obviously and try and gently encourage her to walk, and see how she is by Monday. I just wasn't sure if it was normal or not to not x-ray in these circumstances. I agree though that I would have thought if it was fractured there would be some obvious swelling / flinching and she would be distressed all the time and not just when being asked to stand, so it probably is just sprained, but unfortunately I've had some bad experiences of doctors being wrong so I'm afraid I'm a bit wary of blithely following doctors advice now.

OP posts:

user1471549213 · 09/11/2019 21:19

I've just fractured my ankle for the 2nd time...both times it blew up like a balloon pretty much immediately and I knew it was broken. This break.is a very tiny one but still very obvious. I'm a week on and it's still swollen and I can tell you the pain at the site was horrendous as soon as they put pressure on it so if you LO isn't reacting to pressure on the foot then maybe it isn't broken. But it doesn't explain why they are crying if they aren't in pain. Take their advice they'll.only x-ray where necessary. I'm 31 weeks pregnant and did it because it was necessary to determine treatment they obviously don't feel this is necessary yet for your LO. Maybe it is just a sprain and giving it a few days will make that decision for them rather than exposing them to the x-ray. I was trussed up with lead blankets to cover my bump to ensure minimum exposure so they really don't do them unless necessary

helpfulperson · 09/11/2019 21:23

As we understand more about the potential risks x rays are done much less frequently. I know this comes as a surprise to those of us who grew up in the xray everything generation.

So long as they gave you clear advise o symptoms which would prompt a return visit its fine.

redchocolatebutton · 09/11/2019 21:29

dc had a green stick fracture without obvious swelling.
the pain was also not constant, only when they tried to put weight on that leg.

pain in small dc can be deferred, might actually be the hip, has that been checked as well?

Original poster

KitKat1985 · 09/11/2019 21:32

Hip wasn't checked no.

Will keep a close eye on her for the next couple of days though.

OP posts:

RachelEllenR · 09/11/2019 21:37

They didn't want to xray my daughter's arm as she wasn't reacting badly to their examination but I pushed, they did xray and it was broken (she wasn't using it but she was perfectly happy and wasn't in pain, just discomfort when using it) so don't think your experience is uncommon.

Blinkingblimey · 09/11/2019 21:41

One of my dds dislocated her elbow when she was 5....it didn’t hurt unless she tried to move it or hold something. I was totally in the ‘oh let’s see how it goes’ camp, luckily the friend I was with insisted we get it checked out...fab French doc (sigh at the European efficiency compared to what we deal with here) sorted an X-ray and manoeuvred everything back in quite literally the blink of an eye. Tbh I’m horrified, but not surprised, that you’ve been sent away without anyone bothering to actually thoroughly assess the possibilities. Really hope it does turn out to be a sprain!!

OnlineShopping · 09/11/2019 21:47

I don’t think they are saying they won’t X-ray her; they have checked and don’t believe she has a break but if you return in two days’ time and she is the same, their policy will probably be to X-ray then. Yes fractures do get missed but far more unnecessary X-rays happen than need to.

apple0pie · 09/11/2019 21:49

I had a 14 mth old who wasn't walking in and wouldn't put any weight on their foot. But they seemed ok in them selves and decided to take to A&E to be safe but I assumed it was a sprain and it turned out to be a hairline fracture which required a plaster cast so I'm surprised they didn't X-ray. Go back if your worried

mineofuselessinformation · 09/11/2019 21:53

I'm surprised at pp who have suggested that a break doesn't hurt all of the time. If supported in an appropriate way, a break doesn't hurt - that's the whole point of putting a cast on (as well as letting the break heal).
I'd take her back tomorrow if she's the same, OP.

Sammy867 · 09/11/2019 21:54

Yes we had the same. A 2 year old fell over and went to a and e so thy no weight bearing. They wanted an x ray to rule out a toddler fracture. It’s weighing risks and benefits to be honest as the dose of modern digital xrays are very small compared to a transatlantic flight for example (yet everyone still flies)

Candle1000 · 09/11/2019 21:59

I’m a Radiographer and would have x rayed her . Kids this young don’t know how to ‘fake’ pain as it were . The dose of radiation is minimal, I would expect a spiral fracture.

MintyMabel · 09/11/2019 22:14

And I think if she'd fractured it she'd be in pain constantly - she wouldn't be "okay in herself" when sat down.

Not true. DD broke her leg when she was two. We don't actually know when it happened, suspect it was overnight but was discovered at nursery. She had done nothing there except sleep.

There were very few tears, she didn't complain of any pain, she just couldn't stand on it.

They x rayed that day and saw a fracture.

Best to avoid x rays if possible, but I wouldn't be keen to take a child home with a suspected break.

randomsabreuse · 09/11/2019 22:20

Small fractures often need time to heal a little to show up on x-ray- the callus is more visible than some fractures!

Candle1000 · 09/11/2019 22:27

By the time a callus has formed, it’s too late to do anything. A fractured scaphoid doesn’t always show immediately, so it will be x rayed again in a few weeks .

Original poster

KitKat1985 · 10/11/2019 07:50

So to update she's still not weight bearing on it this morning but there is literally no bruising or swelling at all. I genuinely can't make out if she really can't weight bear or if she's just scared to use her foot in case in hurts. Have given her some more calpol to see if it helps. Ironically we've got tickets to take her out to the zoo today (it was her 3rd birthday on Friday) so will see how she gets on with the buggy today and if she might try and brave standing if she's distracted by the animals which I think will be a good 'test' as I know she'll want to get up and see things if she can. I've decided if she's still not putting weight on it by tomorrow morning I'll take her back to A&E whilst DD1 is at school.

OP posts:

Candle1000 · 10/11/2019 11:19

Young children don’t weight beat because they can’t- I have seen this so many times - like I said , I’m a Radiographer and I would take her back to A &E now tbh.

Candle1000 · 10/11/2019 11:19

*bear

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