Make safety a priority as children prone to falls

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Dr Maria Wong

KUCHING: All parents must watch out for the safety of their children, especially during the festive season, as families gear up to celebrate Raya this year.

The Ministry of Health (MoH) has found that falls are the most common injuries to occur within the comfort of one’s home, with children aged between one and four being more prone as they explore the world around them whilst their bodies and bones are developing.

Dr Maria Wong, an Orthopaedic, Trauma and Paediatric Orthopaedic consultant from Sunway Medical Velocity Centre (SMVC) finds that the injuries tend to be seen often during the festive season as more movement and travelling are involved.

“Most common fractures in children tend to occur in the elbow, forearms and wrist as they try to break their falls by landing on outstretched hands. Different fracture patterns can be observed in different age groups,” she said.

For young children under the age of four, she said incomplete fracture patterns such as plastic deformation (the deformation of a bone), buckle (when a bone slightly crushes in on itself) and greenstick fractures (when a bone bends and cracks) can happen without obvious severe deformity.

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“Sometimes older children may have a growth plate injury – all of this may be overlooked as a simple bruise or soft tissue injury,” she stressed.

Dr Wong added that young children may not be able to articulate their symptoms or pinpoint the exact location of the injury, so adults should pay attention to their reactions and look out for signs that are out of the ordinary.

“A witnessed fall or injury leading to progressive pain and swelling over the limb after 48-hours is a sign that there may be a fracture. The child may refuse to use the limb or cry upon touching or moving the joint.”

Dr Wee Tong Ming, Medical Director and Consultant Emergency Physician from SMCV explains that parents should seek treatment immediately if there is severe pain or deformity of the affected limb.

“If the child refuses to move or use the injured limb, or if swelling does not subside after 48 hours, they should visit a doctor. Treatment is important.”

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For displaced fractures, when the bone fragments are out of alignment, he said that splinting is needed as excessive movement may cause secondary injuries to the surrounding structures such as nerves and blood vessels.

“Even for milder injury, it is crucial to seek early treatment as well – the fracture may be missed without investigations such as x-rays,” he said.

For injuries such as a growth plate fracture, Dr Wee said that delayed diagnosis and treatment may cause stunted growth of the affected bones and impact a child’s life.

In most cases, healing from bone fractures can take anywhere from six to 12 weeks, depending on the fracture site.

Dr Wee thus encouraged parents to ensure that the child follows the treatment plan given by the doctor, which may involve casting or splinting of the limb, and even surgery.

“Emotional support throughout the journey is also important so that the children know that this is all part of the necessary recovery process,” he said.

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Aside from encouragement from the parents, Dr Wong notes that some time out in the sun – with proper supervision – is beneficial.

“A good dose of sunshine helps with Vitamin D absorption which is crucial for strong bones development. A diet or formula milk fortified with Vitamin D and calcium is great for growing bones,” she added.

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