Closed Hand Fracture (Child)  

Your child has a hand fracture. This means that one or more bones in the hand are broken. A closed fracture means that the broken bone has not gone through the skin. A hand fracture will be painful, swollen, and bruised.

To confirm the fracture, X-rays or other imaging tests are done. Then the hand is often put into a splint or cast. This is done to hold the bone in place while it heals. Severe fractures may require surgery.

Home care

Medicines

  • Your child’s healthcare provider may prescribe medicines for pain and swelling. Or your child may use over-the-counter medicine as directed by the provider. Follow the provider’s instructions when giving these medicines to your child. 

  • Always talk with your child's provider before giving these medicines if your child has chronic liver or kidney disease, or has ever had a stomach ulcer or GI (gastrointestinal) bleeding.

  • Don’t give ibuprofen to a child younger than 6 months old. 

  • Don’t give your child aspirin. Taking aspirin can put your child at risk for Reye syndrome. This is a rare but very serious disorder that most often affects the brain and the liver.

General care

  • Keep the injured hand raised to reduce pain and swelling. This is most important during the first 48 hours after injury. As often as possible, have your child sit or lie down and raise the arm above heart level. You can do this by placing your child’s arm on a pillow that rests on his or her chest. Or you can place your child’s arm on pillows at his or her side.

  • Apply an ice pack to the injured area to control swelling. Hold the pack on the injured area for 15 to 20 minutes every 1 to 2 hours for the first day. Continue this 3 to 4 times a day for the next 2 days, then as needed to ease swelling. To make an ice pack, put ice cubes in a plastic bag that seals at the top. Wrap the bag in a clean, thin towel or cloth. You can place the ice pack inside the sling and directly over the splint or cast. Never put ice or an ice pack directly on the skin. As the ice melts, be careful that the cast or splint doesn’t get wet.

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

  • Keep the splint or cast dry at all times. Have your child bathe with the splint or cast out of water, protected with 2 large plastic bags. Place 1 bag outside of the other. Tape each bag with duct tape at the top end. For young children, you may want to use rubber bands instead of duct tape. Water can still leak in even when the hand is covered. So it's best to keep the cast or splint away from water. If a fiberglass cast or splint gets wet, dry it with a hair dryer on a cool setting.

Follow-up care

Follow up with your child’s healthcare provider, or as advised. Follow-up X-rays may be needed 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 your child was referred to a specialist, make that appointment promptly.

If X-rays were taken, you will be told of any new findings that may affect your child’s care.

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 don't get upset.

When to seek medical advice

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

  • Fever (see "Fever and children" below)

  • The plaster cast or splint becomes wet or soft

  • The fiberglass cast or splint stays wet for more than 24 hours

  • The cast or splint has a bad smell

  • The plaster cast or splint becomes loose

  • There is increased tightness or pain under the cast or splint

  • The fingers on the injured hand are cold, blue, numb, or tingly

Fever and children

Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.

For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.

Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.

Infant under 3 months old:

  • Ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider

  • Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider

Child age 3 to 36 months:

  • Rectal, forehead, or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider

  • Armpit (axillary) temperature of 101°F (38.3°C) or higher, or as directed by the provider

Child of any age:

  • Repeated temperature of 104°F (40°C) or higher, or as directed by the provider

  • Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older.

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