Broken Kneecap (Child)

Home care

• If your child has been given crutches, your child should use them to walk. Your child shouldn't walk or put weight on the injured leg until the health care provider says it’s okay.

• Give your child pain medicine as directed by the provider. Don't give your child aspirin unless told to by the provider.

• Keep the child's foot raised (elevated) to reduce pain and swelling. This is very important during the first 48 hours after injury. As often as you can, have the child sit or lie down and place pillows under the child’s leg until the foot is raised above the level of the heart. For babies and toddlers, lay the child down and place pillows under the leg until the injury is raised above the level of the heart. Be sure the pillows don't move near the face of the baby or toddler. Never leave the child unsupervised.

• Apply a cold pack to the injury to help control swelling. You can make an ice pack by putting ice cubes in a plastic bag that seals at the top. Wrap the bag in a thin towel. As the ice melts, be careful that the cast or splint doesn’t get wet. Don't place the ice pack directly on the skin because this can cause damage. 

• Ice the injured area for up to 20 minutes every 1 to 2 hours the first day. Continue this 3 to 4 times a day for the next 2 days, then as needed. It may help to make a game of using the ice. But don't force your child to use the ice.

• Care for a splint or cast as you’ve been instructed. Don’t put any powders or lotions inside the splint or cast. Don't let your child stick objects into the splint or cast.

• Keep the splint or cast dry. The splint or cast should be protected with a large plastic bag closed at the top with tape or rubber bands and kept out of the water.

• Encourage your child to wiggle or exercise the toes on the foot of the injured leg often.

Follow-up care

Follow up with your child's health care provider 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 you were referred to a specialist, make that appointment promptly.

Special note to parents

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

When to get medical care

Contact your child's health care provider right away if:

• The splint or cast is wet or soft.

• The splint or cast is too tight. Loosen a splint before calling for help.

• Swelling or pain gets worse after the cast or splint is put on. Babies not yet old enough to talk may show pain with crying that can't be soothed.

• Toes of the foot on the injured leg are cold, blue, numb, burning, or tingly.

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

• There is redness, warmth, swelling, or drainage from the wound, or a foul odor from a cast or splint.

• Your baby has fussiness or crying that can't be soothed.

• Your child has a fever. (See "Fever and children" below.)

• Your child has chills.

Call 911

Call 911 if your child has:

• Trouble breathing.

• Confusion.

• Trouble waking up or is very drowsy.

• Fainting or loss of consciousness.

• A fast heart rate.

• A seizure.

• A stiff neck.

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 health care 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 it 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 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 health care provider what type to use instead. When you talk with any provider about your child’s fever, tell them which type you used.

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

When to call a health care provider about your child’s fever

For a baby under 3 months old:

• First, ask your child’s health care 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

• A fever of ___________as advised by the provider

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 provider

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 provider