Arm or Leg Trauma

Injury Definition

• Injuries to a bone, muscle, joint or ligament
• Injuries to arms and legs
• Types of injuries include the following:
  • Fractures (broken bones)
  • Dislocations (bone out of joint)
  • Sprains – stretches and tears of ligaments
  • Strains – stretches and tears of muscles (e.g. pulled muscle)
  • Muscle overuse injuries from sports or exercise (e.g. shin splints of lower leg)
  • Muscle bruise from a direct blow (e.g. charley horse of thigh muscles)
  • Bone bruise from a direct blow (e.g. hip or elbow)

See More Appropriate Topic

• If involves finger or toe, see Finger or Toe Trauma

Call 911 Now (your child may need an ambulance) If

• Serious injury with multiple fractures
• Major bleeding that can’t be stopped

Call Your Doctor Now (night or day) If

• You think your child has a serious injury
• Looks like a broken bone or dislocated joint
• Swollen elbow or any large swelling
• Skin beyond the injury is pale or blue
• Age < 1 year old
• Severe pain
• Won’t stand, walk or has a bad limp when walking
• Unable to move arm normally (especially if someone pulled on the arm)
• Joint nearest the injury can’t be moved fully (opened and closed)
• Knee injury with a “snap” or “pop” felt at the time of impact.

Call Your Doctor Within 24 Hours (between 9 and 4) If

• You think your child needs to be seen

Call Your Doctor During Weekday Office Hours If

• You have other questions or concerns

Parent Care at Home If

• Bruised muscle or bone
• Mild strained (pulled) muscle
• Mild sprained (stretched) ligament

Home Care Advice for Mild Pain, Mild Swelling or Mild Limp

1. Treatment of Strained Muscle, Bruised Muscle or Bruised Bone:
   • Apply an ice bag or massage the area with ice for 20 minutes per hour. Repeat for 4 consecutive hours. After 48 hours, use local heat for 10 minutes 3 times per day to help reabsorb the blood
   • Give acetaminophen or ibuprofen 4 times per day for pain. Continue for at least 48 hours
   • Rest the injured part as much as possible for 48 hours
   • For strained muscles, teach the youngster about stretching exercises and conditioning
2. Treatment of Mild Sprains of Ankle or Knee
   • First aid: immediate compression and ice to reduce bleeding, swelling, and pain
   • Treat with R.I.C.E. (Rest, Ice, Compression, and Elevation) for the first 24 to 48 hours
   • Apply compression with a snug, elastic bandage for 48 hours
   • Numbness, tingling, or increased pain means the bandage is too tight
   • Apply crushed ice in a plastic bag for 20 minutes per hour. Repeat for 4 consecutive hours
   • Give acetaminophen or ibuprofen 4 times per day for pain. Continue for at least 48 hours
   • Keep injured ankle or knee elevated and at rest for 24 hours
   • After 24 hours, allow any activity that doesn’t cause pain
3. Expected Course: Pain and swelling usually peak on day 2 or 3. Swelling is usually gone by 7 days. Pain may take 2 weeks to completely resolve
4. Call Your Doctor If
   • Pain becomes severe
   • Pain is not improving after 3 days
   • Pain lasts > 2 weeks
   • Your child becomes worse or develops any of the “Call Your Doctor” symptoms