SPORTS MEDICINE: SPRAINS IN CHILDREN

Sprains are injuries to the ligaments that connect bones together. A sprain occurs when a ligament is stretched excessively or torn. Sprains are very uncommon in young children, because the ligaments are usually stronger than the growing bones and cartilage to which they are attached. Therefore, the growing part of the bone might separate or tear away before the ligament is injured.

In young children, the ankle is far and away the most commonly sprained joint, followed by the knee and wrist. In a mild sprain (grade 1), the ligament is simply overstretched. More severe sprains can involve partial tearing of the ligament (grade 2) or a complete tear (grade 3). The signs and symptoms of sprains in young children can be quite similar to those for fracture: pain; swelling around the joint; and inability to walk, bear weight or use the joint.

Treatment of Sprains

You should call your child's pediatrician if there is any evidence that a joint injury has occurred. Your doctor will often want to examine the child. If the pain and swelling are excessive or if there is concern about a fracture, your pediatrician may recommend a consultation with an orthopedic surgeon. The orthopedist may need to perform special X-rays to distinguish between an injury to a ligament or a bone.

When a sprain is diagnosed, the joint is usually immobilized with an elastic bandage or a splint. Crutches may be necessary in the case of a leg sprain, to prevent continued stress on the injured ligament. A cast may be necessary if the injury has been severe.

Most grade 1 sprains will heal within two weeks and without subsequent complications. In certain grade 3 injuries, especially around the knee, an operation may be necessary to repair the damage. Your child's physician should be called any time a joint injury fails to heal or swelling recurs. Ignoring these signs could result in more severe damage to the joint and long-term disability.