Closed Hand Fracture (Child)

Home care

Medicines

• Your child’s health care 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 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 their chest. Or you can place your child’s arm on pillows at their side.

• Check often to make sure your child's fingertips are pink and able to wiggle. If there is a change in the movement or color of the fingers, contact your health care provider immediately.

• 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 two large plastic bags. Place one 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 health care 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

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. Providers are required by law to ask you these questions. This is done for the protection of the child. Please try to be patient and don't get upset.

When to get medical advice

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

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

• Your child has chills.

• The cast or splint becomes wet or soft.

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

• The cast or splint has a bad smell.

• The 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.

• The cast or splint cracks or breaks.

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 they are 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 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 contact the provider if your child has a fever. Your child’s provider may give you different numbers. Follow their instructions.

When to contact 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.