Lessons Learned: Toddler Broken Bones

I want to share an important lesson we learned with our daughter, Sabrina, with the hope that other parents can learn from all of our mistakes on this one.

When Sabrina was just shy of two years old, she came home from Grandma's ranch with a very fat middle finger. Nobody saw what happened, but the suspicion is she dropped a very heavy lid from Grandma's outdoor storage bin on it. Her finger didn't look any better by Monday, so I called our pediatrician's office. The nurse suggested watching it for a few days, but if the swelling didn't go down by the end of the week, to make an appointment with the local pediatric orthopedic office. Still twice as large as her other fingers, we made an appointment that Friday.

The first doctor we saw immediately took an x-ray and showed us the small break in Sabrina's finger. She suspected that our active two-year-old would not be very happy with a splint on her finger and recommended wrapping it in some pretty pink tape to the next finger over, limiting the use of her hand as much as we could and coming back to check it in a week.

We tried to keep it wrapped as much as we could, but Sabrina unwrapped it often. When we returned to the office a week later, it looked exactly the same as it had when we left. This time we had a new doctor - a specialist in hands. He put a splint on it and wrapped it, said she needed to use her hand as little as possible, and come back in another week.

It was very hard to keep the splint on Sabrina's finger. I will admit it was probably off more than it was on. The next week it was still as fat as a cocktail hot dog. The doctor took another x-ray and it showed the same break that wasn't healed. We were starting to get worried at this point. Was there something wrong with her body that she couldn't heal a broken bone? Was there an infection in the bone? He recommended we schedule a MRI to make sure there wasn't a more serious issue at hand (pun intended).

A MRI for a two-year-old is an ordeal because they have to be under sedation. I wish I had gotten a second opinion, but we were already seeing the pediatric orthopedic specialist and the doctor we were dealing with was their hand specialist! There's a reason for the phrase hindsight is 20-20. So we had an MRI (an ordeal all on its own) and were scheduled to go back to the orthopedic office the next day. Our hand specialist was at a Hand Conference, so we met with the office's most senior doctor. And this is where we learned our biggest lesson.

The senior doctor said, "Everything looks fine with her finger except that there is still swelling and a break there. I understand why Dr. So-and-so ordered the MRI, but what I've learned in 35 years of cases is that with toddler broken fingers and toes, you have to cast them. Otherwise, they're just aggravating those broken bones over and over in their everyday play." So we were essentially preventing the bone from healing because it wasn't completely protected. Needless to say, I wish we'd had this doctor first.

They put on a cast that morning. Sabrina handled it well - actually seemed to like it a little - and when it finally came off a few weeks later, the finger was looking 60% better (still swollen but the break had healed). It wasn't until a month or two later that it finally looked like a normal middle finger.

Lesson Learned Recap - Cast any broken finger or toe in a child under three years old. Wrapping and splints aren't likely to cut it! It took us five appointments, an MRI and $2,000+ to learn this very simple lesson.