My 8-year-old son broke the larger bone in his arm about four inches above his wrist. The bone fractured completely and displaced. The doctor set the bone without opening up the skin. However, a week later, the new X-ray showed the bones were about a quarter-inch offset in the bones not matching up exactly. The doctor indicated this was normal and that in an 8-year-old boy the bone would eventually heal and the offset would disappear. Is this true, or should we seek a second opinion?
It always amazes me how well children’s bones heal and remodel themselves. It is common that a fractured bone is not perfectly lined up when it is placed in a cast. Buckle fractures are slightly angled, like a gentle “V.” Others will be slightly displaced so the ends don’t line up. Both of these heal very well. As the bone heals, a large bone scar forms around the ends of the fracture. Over several months to years, the scar resolves and the new bone looks almost exactly like the bone did before the fracture. Although the bone is scarred, your son will feel nothing peculiar, and he will be able to use the arm just fine.
The only place where it is important to be sure the bone fragments are lined up well is at the growth plate. The growth plate is at the ends of bones in children and generally remains open until puberty in girls and early adulthood in boys. Fractures in this area that are not well aligned will cause uneven growth of the bone or will perhaps stunt the bone growth.