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Fracture vs. Sprain: Symptoms & Treatments

Fracture vs. Sprain: Symptoms & Treatments

How to tell if your child's injury is a fracture or a sprain, and what the treatment plans are for each.


With their knack for falling, running, jumping, and the like, kids are the common victims of bumps and bruises, but occasionally they can sustain a more serious injury—especially when playing sports. Broken bones can be scary for any parent, but Jon-Paul DiMauro, M.D., orthopaedic surgeon at Northwell Health, shares everything you need to know about broken bones and sprains.

Is it a Broken Bone or a Sprain?

It can be difficult to differentiate between what may seem like a sprain compared to a broken bone that requires more medical attention. Looking at the symptoms of an injury is usually good way to determine whether it is a bruise, sprain, or break. For example, swelling is common in most injuries, but an increase in swelling can indicate an increase in severity. It is also common to see the injured area become black and blue or red, but more severe redness or a bruise can also be indicative of a more serious injury, such as a fracture.

A telltale sign of a more serious injury is crepitus, or a crunching sensation, that occurs with an injury and can feel “like rice krispies under the skin,” Dr. DiMauro says.

Other signs to help parents differentiate between sprains and fractures is their child’s ability to bear weight on the extremity—especially if the inability to bear weight persists. A decreased range of motion, or an inability to move and use the injured area, can also indicate that the injury is more serious.

If it is a sprain, there should be significant improvement within 24 hours, according to Dr. DiMauro. If there is no improvement, or the symptoms get worse, it may be a sign of a more serious injury. Children can have what are called “buckle fractures,” which is when the bone does not break all the way through—it “crunches like a soda can,” Dr. DiMauro says. These injuries are treated like a sprain but can be as painful as a fracture, and may require additional medical attention.

Some signs that an injury is serious, and parents should seek medical attention include:

  • If the limb looks deformed in some way, and does not mirror the opposite side

  • If the injury is open in any way—especially if parents can see bone (Open injuries put the child at risk for osteomyelitis, or an infection of the bone, and therefore must be treated immediately.)

Unusual but Serious Fractures

Other fractures that are serious, but more unusual, include pelvic and rib fractures. Pelvic fractures are often a result of a serious injury such as a fall from a great height, according to Dr. DiMauro, but they can also occur as a result of a dynamic injury, such as when a child tries to stop after running really fast. These are usually treated symptomatically—by only treating the symptoms of pain and swelling without surgery—and with physical therapy to allow the fracture to heal.

Though rib fractures happen in children, they are somewhat uncommon. While a rib fracture can be very painful, treatment is again usually symptomatic, even if there are multiple ribs involved. If a rib fracture is causing deep injuries, such as issues with the lungs, it may require more serious medical attention.

Healing Time for Sprains and Broken Bones

A low-grade sprain can take one to two weeks to heal, and sometimes up to three weeks to get back to normal activity, Dr. DiMauro says. A more severe sprain can take up to three months to heal enough for a child to return back to her previous activities.

Fractures can take anywhere from four to six weeks to heal, but the younger the child, the quicker the healing time. However, with immobilization in a cast or other splint for that amount of time, the child can have issues related to disuse, and it can take a while for him to recover completely.

Treating Minor Sports Injuries at Home

There are things parents can do for their child at home for injuries that do not merit immediate medical attention. “The pneumonic that I learned that is really how I treat a lot of injuries, I learned in third grade,” Dr. DiMauro says. “RICE is applicable to sports injuries and injuries in general.” These are four easy ways for parents to try and make their child more comfortable: 

  • Rest: Crutches, slings, ankle braces, and other similar devices can help prevent movement of the injured area. Parents should not try to force their kids to walk on the extremity, because if it is a fracture, it can end up making the injury a lot worse.

  • Ice: Parents should apply ice to the area for 20 minutes on and 20 minutes off.

  • Compress: Ace bandages may be useful in helping to compress the injury and in turn reduce swelling.

  • Elevate: Putting the injured limb up on a pillow is also important to help decrease swelling.

Dr. DiMauro says he suggests RICE to patients with musculoskeletal injuries unless they cannot bear weight, there is crepitus or that crunching feeling, failure to improve, or worsening symptoms. Parents can also give their child anti-inflammatories, such as Advil and Motrin, which help with both swelling and pain (unlike Tylenol, which is only good for pain). If, despite these measures, there is persistent pain and it’s as bad as when it started, it may indicate a more severe injury that requires additional medical attention.

Multiple Sports Injuries and How Parents Can Help Prevent Them

If your child seems to be sustaining multiple sports injuries, there could be a couple of reasons why. Sometimes it is a result of parents pushing children beyond their limits, Dr. DiMauro says. There could also be an underlying problem related to the child’s genetics or metabolism. More recently, there has been research about how vitamin D deficiency can be the cause of two or more fractures in children, Dr. DiMauro says. It is now becoming more common for children who have sustained two or more fractures to get a blood test for calcium and vitamin D levels, he adds.

To prevent these injuries in kids, Dr. DiMauro emphasizes the importance of a good nutrition and healthy sleep patterns. “Parents can…get their kids well nourished and give them the appropriate sleep to dramatically decrease injuries,” he says.

Dr. DiMauro says it is also important for kids to cross train and not lock themselves into one sport, no matter how much they or the parents want them to succeed at one sport. “Overuse injuries come from repetitive injuries,” Dr. DiMauro says. That is why it is important to try different sports, so children use different muscles in order to prevent repeat injuries that can keep them from playing for extended periods of times. Overall, making sure that your child is healthy is the best way to prevent any kind of sports injury so they can continue to play at their fullest potential. 


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Author: Casey Heely, a former editorial intern for NYMetroParents, studied English Journalism and Nursing at Fairfield University. Her interest in nursing is pediatrics, which translates into her desire to write about children and their families. See More

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