Buckle (Torus) Fracture of a Leg

Home care

Follow these guidelines when caring for your child at home:

• Your child will be given a splint, cast, or special boot to keep them from moving the leg. Your child should not put weight on a splint, or it will break. Follow the doctor's advice on when your child can start bearing weight on a cast or boot.

• Keep your child's leg elevated when they are sitting or lying down. This is very important during the first 2 days (48 hours) after the injury.

• Keep the splint, cast, or boot completely dry at all times. When your child bathes, protect the splint, cast, or boot with 2 large plastic bags, taped or rubber-banded at the top end. If a fiberglass cast or splint gets wet, you can dry it with a hair dryer on the cool setting.

• Put an ice pack on the injured area. Do this for 20 minutes every 1 to 2 hours the first day for pain relief. 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 splint or cast doesn’t get wet. You can place the ice pack directly over the splint or cast. 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.

• Your child may use acetaminophen or ibuprofen to control pain, unless another pain medicine was prescribed. If your child has chronic liver or kidney disease, talk with the doctor before giving these medicines to your child. Also talk with the doctor if your child has had a stomach ulcer or gastrointestinal bleeding. Don’t give ibuprofen to children younger than 6 months of age.

• Don’t put creams, lotions, or objects under the cast. If itching continues, contact your doctor.

Follow-up care

Follow up with your child’s doctor as advised. This is to make sure the bone is healing the way it should. If your child was given a splint, it may be changed to a cast after the swelling goes down.

If X-rays were taken, a radiologist may look at them. You will be told of any new findings that may affect your child's care.

When to get medical advice

Contact your child’s doctor right away if:

• The cast or splint cracks.

• The plaster cast or splint becomes wet or soft.

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

• Tightness or pain under the cast or splint gets worse.

• Toes become swollen, cold, blue, numb, or tingly.

• Your child can’t move the toes on the injured leg.

• The skin around the cast becomes red, swollen, or irritated.

• Your child has a fever (see Fever and children, below) or chills.

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 doctor 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 doctor may want to confirm with a rectal temperature.

• Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.

Use a 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 okay using a rectal thermometer, ask the doctor what type to use instead. When you talk with any health care provider about your child’s fever, tell them which type you used.

Below is when to contact the doctor if your child has a fever. Your child’s doctor may give you different numbers. Follow their instructions.

When to contact a doctor about your child’s fever

For a baby under 3 months old:

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

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

• Armpit: 99°F (37.2°C) or higher

• A fever of ___________as advised by the doctor

For a child age 3 months to 36 months (3 years):

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

• Ear (only for use over age 6 months): 102°F (38.9°C) or higher

• A fever of ___________ as advised by the doctor

In these cases:

• Armpit temperature of 103°F (39.4°C) or higher in a child of any age

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

• A fever of ___________ as advised by the doctor