Injury Definition

• Injuries to a bone, muscle, joint or ligament.
• Injuries to arms and legs.
• Types of injuries include the following:
  - Fractures (broken bones)
  - Dislocations (bone out of joint)
  - Sprains - stretches and tears of ligaments
  - Strains - stretches and tears of muscles (e.g., pulled muscle)
  - Muscle overuse injuries from sports or exercise (e.g., shin splints of lower leg)
  - Muscle bruise from a direct blow (e.g., charley horse of thigh muscles)
  - Bone bruise from a direct blow (e.g., hip or elbow)

See More Appropriate Topic

• If involves finger or toe, see FINGER OR TOE TRAUMA.

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Call 911 Now (your child may need an ambulance)

• Serious injury with multiple fractures.
• Major bleeding that can't be stopped.

Call Your Doctor Now (night or day) If

• You think your child has a serious injury.
• Looks like a broken bone or dislocated joint.
• Swollen elbow or any large swelling.
• Skin beyond the injury is pale or blue.  
• Age less than 1 year old.
• Severe pain.
• Won't stand, walk or has a bad limp when walking.
• Unable to move arm normally (especially if someone pulled on the arm).
• Joint nearest the injury can't be moved fully (opened and closed).
• Knee injury with a "snap" or "pop" felt at the time of impact.

Call Your Doctor Within 24 Hours (between 9 and 4) If

• You think your child needs to be seen.

Call Your Doctor During Weekday Office Hours If

• You have other questions or concerns.

Parent Care at Home

• Bruised muscle or bone.
• Mild strained (pulled) muscle.
• Mild sprained (stretched) ligament.

Home Care Advice for Mild Pain, Mild Swelling or Mild Limp

1. Treatment of Strained Muscle, Bruised Muscle or Bruised Bone:
   
   Apply an ice bag or massage the area with ice for 20 minutes per hour.  Repeat for 4 consecutive hours. After 48 hours, use local heat for 10 minutes 3 times per day to help reabsorb the blood.
   
   Give acetaminophen or ibuprofen 4 times per day for pain.  Continue for at least 48 hours.
   
   Rest the injured part as much as possible for 48 hours.
   
   For strained muscles, teach the youngster about stretching exercises and conditioning.
   
   
2. Treatment of Mild Sprains of Ankle or Knee:
   
   First aid: immediate compression and ice to reduce bleeding, swelling, and pain.
   
   Treat with R.I.C.E. (rest, ice, compression, and elevation) for the first 24 to 48 hours.
   
   Apply compression with a snug, elastic bandage for 48 hours.  Numbness, tingling, or increased pain means the bandage is too tight.
   
   Apply crushed ice in a plastic bag for 20 minutes per hour.  Repeat for 4 consecutive hours.
   
   Give acetaminophen or ibuprofen 4 times per day for pain.  Continue for at least 48 hours.
   
   Keep injured ankle or knee elevated and at rest for 24 hours.
   
   After 24 hours, allow any activity that doesn't cause pain.
   
   
3. Expected Course:  Pain and swelling usually peak on day 2 or 3.  Swelling is usually gone by 7 days.  Pain may take 2 weeks to completely resolve.
   
   
4. Call Your Doctor If:
   
   Pain becomes severe.
   
   Pain is not improving after 3 days.
   
   Pain lasts more than 2 weeks.
   
   Your child becomes worse or develops any of the "Call Your Doctor" symptoms.

Parent Care for Pediatric Symptoms. Copyright © 2000. Barton D. Schmitt, MD, FAAP

See related topics:

Finger or Toe Trauma