Treatment of Compression Fractures in Children
Spinal compression fractures are common in children. The main cause of these injuries is excessive activity, which often leaves children unable to sit still, either at home or outdoors. In adults, such injuries are often associated with age-related changes in bone tissue.
Treatment of compression fractures offers the opportunity to avoid serious consequences and fully restore spinal function.
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What is a compression fracture and why is it dangerous?
A spinal compression fracture is the compression of one or more vertebrae. As a result, the bone tissue cannot withstand the pressure, and the vertebra loses height, becoming wedge-shaped. This deformity is dangerous because it compromises the stability of the entire spinal column.
The main danger lies in the hidden nature of the injury. Since a child's spine is elastic, the tissues can partially heal on their own, but without medical supervision, this leads to malunion. This subsequently provokes the development of early osteochondrosis, persistent postural changes, and the development of a pathological curvature called kyphosis.
How does a spinal compression fracture occur?
The mechanism of injury is most often associated with a sharp bending of the torso or a strong impact along the axis of the spinal column. This is called an axial load. When a child lands on straight legs or on their buttocks after a fall from a height, the force of the impact is transmitted along the spine. At a certain point (usually in the lower thoracic or lumbar region), the load exceeds the bone's breaking point, causing a fracture.
How does a child's injury differ from an adult's?
The child's skeleton has a number of anatomical features. Children's bones contain more organic matter, are more flexible, and the periosteum (bone shell) is thick and well-perfused. Therefore, a compression fracture in a child often follows a "greenstick" pattern, where the outer shell of the bone remains intact, and only the internal structures are damaged. This complicates diagnosis, as external signs may be minimal. However, due to the body's continued growth, any deformity can progress, interfering with proper skeletal development.
Degrees of Vertebral Compression
Doctors classify the injury based on the severity of the vertebral body deformation:
- Grade I: the height of the vertebral body is reduced by less than 30%. This is the most common type of injury in children and responds well to conservative treatment.
- Grade II: Height loss ranges from 30% to 50%. Requires strict adherence to a regimen and long-term rehabilitation.
- Grade III: The vertebra is flattened by more than 50%. This is a severe spinal injury that may be accompanied by nerve damage.
Symptoms of a muscle strain in a child
Children's activity is a major source of injury. It's important for parents to understand that even ordinary play can cause serious injury if the spine is exposed to forces it isn't designed for.
Falls, sports, active play, and other causes
Spinal fractures in children usually occur as a result of a fall. Other causes include contact sports (football, wrestling), gymnastics, or car accidents.
Even falling backward on ice or while running can cause compression if the impact hits the spinal column.
Which children are at risk?
Certain factors make the spine more vulnerable. These include:
- Calcium and vitamin D deficiency: Poor nutrition or metabolic disorders reduce bone density.
- Poor posture: Scoliosis or weak back muscles distribute the load unevenly.
- Osteoporosis or osteopenia: Systemic diseases that cause bones to become brittle.
- Intensive periods of growth: During these periods, bone tissue does not always have time to strengthen.
General information
Diagnosis of Compression Fractures
If there is even the slightest suspicion of a back injury, a professional diagnosis of a compression fracture is essential. Self-medication or waiting for it to "resolve on its own" is unacceptable in this case.
Examination by a pediatric orthopedic traumatologist
The first step is a specialist consultation. The pediatric orthopedic traumatologist performs a visual examination, palpates the spine, and checks neurological reflexes. The doctor assesses range of motion and checks for axial loading to localize the injury.
X-ray of the spine
The main method of initial imaging is an X-ray of the spine. Images are taken in two projections—AP and lateral. This allows one to see changes in the shape of the vertebrae and assess the degree of their loss.
When a CT or MRI is prescribed
In complex cases, the doctor requires additional information:
- A CT scan of the spine is prescribed for a detailed study of bone structure and the detection of small cracks.
- MRI of the spine: the doctor evaluates the condition of the muscles and ligaments.
| Examination method | What it shows | When it is used |
|---|---|---|
| Radiography | The shape of the vertebra, the degree of compression | Primary diagnosis for any injury |
| CT (computed tomography) | Bone structure details, microcracks | If bone damage needs to be clarified |
| MRI (magnetic resonance imaging) | Disc, ligament, and spinal cord conditions | If neurological complications are suspected |
After an injury, it's important to protect your child's spine. Parents should monitor the load.
How to reduce stress on the spine
- Workplace equipment: the chair and table should be appropriate for the child's height.
- Choosing a backpack: An orthopedic backpack with two straps is essential.
- Footwear: High-quality shoes with good cushioning reduce the impact of walking.
What's important for parents after recovery?
Monitor your child's diet and give them more calcium-rich foods.
Strengthen muscles: Swimming is an ideal activity after an injury, as it strengthens muscles without axial loading. Visit an orthopedist every six months for a preventative examination.
Frequently Asked Questions
How can I tell if my child has a compression fracture of the spine?
How long does it take to treat a compression fracture in a child?
Do I need to wear a brace for a compression fracture?
When can my child return to physical activity?
Results and conclusion
Treating compression fractures in children requires discipline, first and foremost.
"In my practice, pediatric compression fractures often look like a common bruise. Therefore, we always evaluate not only the patient's complaints but also the imaging. We recommend returning to physical activity only after a follow-up examination and complete recovery," explains the orthopedic traumatologist.
Don't ignore physical therapy; simple exercises are key to restoring muscle tone.
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Symptoms of a compression fracture in a child
Recognizing a spinal injury in children is very difficult. While adolescents can accurately describe the nature of the pain, children under 7-8 years old are often afraid to even admit to a fall.
Main signs of injury
Symptoms of a compression fracture:
When symptoms are mild
A compression fracture in a child does not always have obvious symptoms. Sometimes, after a blow or fall, a child may be actively playing and having fun. However, parents may notice that their child is acting wary: avoiding sudden movements and momentarily freezing from sudden pain.
Parents may also notice that their child is becoming more easily tired, lying down more often, or trying not to bend over, but squatting with a straight back.
Situations that require urgent medical attention
Seek immediate medical attention if, after a fall, your child experiences: