Closed Finger Fracture (Child)  

Your child has a broken bone (fracture) in a finger. A broken finger will likely be painful, swollen, and bruised.

Finger fractures are usually diagnosed with X-rays. The finger or hand may be put into a splint. Or the injured finger may be taped to the finger beside it (buddy taping). These treatments protect the injured finger and hold the bone in place while it heals. Your child may need more treatment or surgery, depending on where the injury is and how serious it is.  If the fingernail has been injured, it may fall off in 1 to 2 weeks. Or the fingernail may need to be removed surgically. A new fingernail will likely start to grow back within a month.

Home care

Your child’s healthcare provider may prescribe medicines for pain. Follow the provider’s instructions for giving these medicines to your child. Don’t give your child aspirin or other medicine unless the provider tells you to.

General care

  • Keep the hand elevated to reduce pain and swelling. This is most important during the first 2 days (48 hours) after the injury. As often as possible, lay your baby or toddler down and place pillows under the hand until the injured area is raised above the level of the heart. Watch that any pillows don't slip and move near the face of the infant or toddler. For an older child, have him or her sit or lie down. Put pillows under the child’s hand until it's raised above the level of the heart.

  • Put an ice pack on the injured area. Do this for 20 minutes every 1 to 2 hours the first day to ease pain and swelling. You can make an ice pack by wrapping a plastic bag of ice cubes in a thin towel. As the ice melts, be careful that the cast or splint doesn’t get wet. Don’t put the ice directly on the skin, because this can cause damage. It may be hard to use the ice pack because most children don’t like the feel of the cold. Don’t force your child to use the ice. This could make both of you miserable. Sometimes it helps to make a game of it.

  • Continue using the ice pack 3 to 4 times a day for the next 2 days. Then use the ice pack as needed to ease pain and swelling. You can place the ice pack directly on the splint.

  • Care for the splint or cast as you’ve been told. Don’t put any powders or lotions inside the splint or cast. Keep your child from sticking objects into the splint or cast.

  • Keep a splint completely dry at all times. Keep the cast out of the water when your child bathes. Cover the splint with a plastic bag and close the top end of the bag with tape or rubber bands.

  • If buddy tape becomes wet or dirty, change it. You can replace it with paper, plastic, or cloth tape. Cloth tape and paper tape must be kept dry. Keep the buddy tape in place, as directed by your child’s healthcare provider.

Follow-up care

Follow up with your child’s healthcare provider as advised. Your child may need follow-up X-rays to see how the bone is healing. If your child was given a splint, it may be changed to a cast at the follow-up visit. If you were referred to a specialist, make that appointment as soon as you can.

Special note to parents

Healthcare providers are trained to recognize injuries like this one in young children as a sign of possible abuse. Several healthcare providers may ask questions about how your child was injured. Healthcare providers are required by law to ask you these questions. This is done for protection of the child. Please try to be patient and not take offense.

Call 911

Call 911 if any of these occur:

  • Trouble breathing

  • Confusion

  • Very drowsy or trouble awakening

  • Fainting or loss of consciousness

  • Rapid heart rate

  • Seizure

  • Stiff neck

When to seek medical advice

Call your child's healthcare provider right away if any of these occur:

  • Wet splint

  • Splint is too tight. Loosen it before going for help.

  • Swelling or pain gets worse after a cast or splint is put on the hand. Babies too young to talk may show pain with crying that can't be soothed. If the splint is on, loosen it before going for help. It may be on too tight.

  • The injured finger, nearby fingers, or the hand becomes cold, blue, numb, burning, or tingly. If the splint is on, loosen it before going for help.

  • Redness, warmth, swelling, or drainage from the wound, or foul odor from a cast or splint

  • Cast gets wet or soft

  • Fever (see Fever and children, below)

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

  • Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

  • Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

  • Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

  • Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

  • Mouth (oral). Don’t use a thermometer in your child’s mouth until he or she is at least 4 years old.

Use the rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell him or her which type you used.

Below are guidelines to know if your young child has a fever. Your child’s healthcare provider may give you different numbers for your child. Follow your provider’s specific instructions.

Fever readings for a baby under 3 months old:

  • First, ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead: 100.4°F (38°C) or higher

  • Armpit: 99°F (37.2°C) or higher

Fever readings for a child age 3 months to 36 months (3 years):

  • Rectal, forehead, or ear: 102°F (38.9°C) or higher

  • Armpit: 101°F (38.3°C) or higher

Call the healthcare provider in these cases:

  • Repeated temperature of 104°F (40°C) or higher in a child of any age

  • Fever of 100.4° F (38° C) or higher in baby younger than 3 months

  • Fever that lasts more than 24 hours in a child under age 2

  • Fever that lasts for 3 days in a child age 2 or older

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