Children's bones are in the process of growth, so they are often subjected to various injuries. One of the most serious is a compression fracture of the spine. It is rare in a child, but such an injury can have dangerous consequences. Therefore, every parent needs to know how to prevent such injuries, how to recognize that a fracture has occurred, and how to properly provide first aid. Although bones heal faster in children than in adults, healing after such an injury, along with a rehabilitation period, usually takes at least two years.
What is a compression fracture
This is a serious injury to the spine, which is a violation of the integrity of one or more vertebrae due to their compression or sharp pressure. Often it is accompanied by swelling of soft tissues, infringement of nerves or blood vessels. The vertebrae can not only shrink or flatten, but even crack. This happens when jumping or falling fromheight, impact or sudden movement. Most often, a compression fracture of the thoracic spine occurs in children or in the lumbar region. Compression of the vertebrae can lead to damage to the spinal cord and paralysis of the limbs. According to statistics, such injuries rarely occur in children. Indeed, before complete ossification, the spine is quite flexible, and the intervertebral discs are high.
Causes of injury
Compression fracture of the spine in a child can happen even from a minor blow or fall on the buttocks. This is more common in children whose bones are deficient in calcium. This happens with osteoporosis or osteomyelitis. But any child can be traumatized. The most common causes of a compression fracture are:
- falling, especially dangerous when landing on the buttocks;
- bad diving;
- a sharp lean or incorrectly performed somersault;
- car accidents.
Signs of a compression fracture
Sometimes the injury is mild. In such cases, parents may not realize that the child has a compression fracture of the spine. The symptoms of an uncomplicated injury are blurred and resemble signs of a bruise. Therefore, it is important for any fall on the back or buttocks, a blow to the spine, immediately consult a doctor. We need to conduct an examination and find out if there is damage.
It is often possible, by external signs and complaints of a child, to determine that he has a compression fracturespine. Symptoms will vary depending on the type and location of the injury.
- When there is a fracture in the region of the thoracic vertebrae, pain is felt in the shoulder blades. Then it covers the entire chest. In addition, the child is having trouble breathing.
- If the damage has affected the lumbar vertebrae, then there may be pain in the abdomen and tension in the pectoral muscles. Any movement is difficult for the child.
- Forced position of the head and a noticeable deformity in the neck indicate a fracture of the cervical vertebra. The child is in severe pain and the neck muscles are tense.
- More severe symptoms are accompanied by a compound fracture. Damage to blood vessels and nerves leads to numbness of the limbs, their partial paralysis is possible. There is a urinary disorder, muscle weakness and low blood pressure.
The most important symptom of any compression fracture is pain. It can be strong at first, and then almost disappear, or, conversely, it will intensify.
Types of spinal injuries
According to the presence of complications, such injuries are complicated and uncomplicated. The danger of the first type is that the child may not report a slight back pain. And without treatment, such an injury can have serious consequences. Among the complicated ones, a compression fracture of the thoracic spine is especially dangerous. Its consequence may be a violation of the heart and lungs.
Depending on the degree of deformation of the vertebrae, there are three types of injury.
- Compression fracture of the first degree is characterized by a decrease in the height of the vertebra by 30%. Such an injury is successfully treated and, with timely assistance, the prognosis of therapy is favorable.
- Fracture of the second degree is a compression of the vertebra by half. In most cases, serious complications appear after this.
- Deformity over 50% is a very serious injury and is rarely diagnosed in children. Usually a third-degree fracture is characterized by damage to the spinal cord.
Diagnosis of trauma in children
Back pain itself is not a basis for a diagnosis of "compression fracture of the spine". The child may experience such sensations for other reasons. Therefore, if damage is suspected, it is necessary to visit a traumatologist. He will prescribe diagnostic procedures that will help make the correct diagnosis.
- First of all, an x-ray is taken in two projections. This helps to identify where the damage occurred and what its nature is.
- The condition of the spinal cord and the study of the injured spine is done using CT and myelography.
- If there are signs of nerve root damage, an MRI of the spine is performed. Its price is from 2.5 to 7 thousand rubles, but this examination method is really informative.
- You can also do densitometry, which will help identify the presence of osteoporosis in a child.
Features of first aid
The main rule thatmust be observed by adults who are next to the child during the injury - this is to prevent displacement of the vertebrae and their further deformation. To do this, it is necessary to ensure the immobility of the victim and his speedy delivery to the hospital. Spinal injuries are very serious injuries, so it is important to know how to provide first aid for them.
- In case of a compression fracture in the lumbar region, you need to lay the child on his stomach, putting something soft under his head.
- When a chest injury occurs, it is important that the child lies on their back on a flat, hard surface.
- Fracture of the cervical vertebra is especially dangerous because the slightest careless movement can damage the spinal cord. Therefore, you can not touch, and even more so try to correct spinal deformities. It is necessary to cover the child's neck with cotton wool or something soft and bandage it.
- With any spinal injury, the victim should not sit, walk or even turn around.
Compression fracture of the spine in children: treatment
Therapy methods depend on the type of fracture. A complicated injury is treated only with the help of surgical intervention: titanium plates are inserted or cavities in the damaged vertebra are filled with special cement. But such injuries in children are quite rare. Therefore, the most demanded method of treatment of uncomplicated fracture. In order for the prognosis of therapy to be favorable, it is necessary to provide timely assistance, long-term complex treatment and adherence to the sequence in the application of various methods. Most effective forsuch an injury is exercise therapy, massage, breathing exercises and physiotherapy.
A compression fracture is being treated in several stages:
- First 3-4 weeks after injury. All this time the child is in the hospital. Treatment consists of strict bed rest and spinal traction with a Glisson loop or Delbe rings on an inclined bed. The goal of this therapy is to relieve stress on the muscles, prevent further deformity of the vertebrae, and protect the spinal cord from damage. The first few days you still need to relieve pain.
- In the second month after the injury, the task of treatment is to restore the function of muscles and ligaments and prepare the spine for motor loads. After an uncomplicated fracture at this time, the child can already stand up for a short time. The victim should lie on a hard, flat surface without a pillow.
- Almost a year after the injury, active restoration of the functions of the spine takes place. At this time, rehabilitation activities are carried out to restore mobility to muscles and ligaments.
- After that, for another whole year, you need to continue to perform a special complex of exercise therapy and physiotherapy procedures. And only two years after the injury, we can talk about a successful cure.
Compression fracture of the spine: rehabilitation
The child is allowed to get up and walk 1-2 months after the injury. It depends on the gravity andthe nature of the damage. At first, you can only be in a vertical position in a special corset. The doctor prescribes the time of wearing the orthosis individually. But most of the day the child spends the first year lying on his back or on his stomach. The victim should not sit for long periods of time. It is usually allowed to sit after a compression fracture of the spine only after 4-8 months. The corset is worn for at least a year, depending on the nature of the damage.
The tasks of rehabilitation after such an injury are to restore the mobility of the spine, the work of the ligaments, strengthen the muscle corset and improve blood circulation. For this, physiotherapy procedures are used. It is very important that the child regularly perform special physical therapy exercises over the next two years.
Physiotherapy and exercise therapy
They are appointed already a week after the injury. This can be electrophoresis with eufilin to expand capillaries, magnetotherapy, which improves blood circulation, and electrical myostimulation. UHF, paraffin applications, water procedures are also prescribed. Massage is very effective, which is done after the disappearance of pain and is then carried out in courses several times over the next two years.
But the main treatment for a compression fracture is exercise therapy. Its tasks are to strengthen the muscular corset, improve blood circulation and stimulate the gastrointestinal tract. They begin to perform exercise therapy within 3-5 days after the injury. First, these are breathing exercises, muscle tension andlifting hands. It is forbidden to raise the head and legs in the first month. After the disappearance of pain, it is allowed to roll over on the stomach for a short time. The first 1-2 months of exercise are performed only in the supine position. After that, an individual complex for exercises in a vertical position is compiled.
Possible consequences of injury
The most common uncomplicated compression fracture of the spine in a child. Usually, recovery after an injury is successful, and after a couple of years the victim may forget about the damage. In 90% of cases, such fractures resolve without consequences. But with untimely assistance or lack of treatment, as well as after a more serious injury, complications often occur:
- curvature of the spine, most often scoliosis and kyphosis;
- after some time osteochondrosis develops;
- radiculitis is a common consequence of a compression fracture;
- very dangerous spinal stenosis, which leads to poor blood circulation;
- The most severe consequence of an injury can be complete paralysis of the lower extremities.
Prevention of compression fractures in children
In fact, it is very difficult to protect a child from falling. But parents need to know that those with osteoporosis are most susceptible to fractures from minor injuries. Therefore, it is necessary to regularly examine the child's skeleton and prevent a lack of calcium and vitamin D in his diet. After each fall, especially on the back, it is advisable tosurvey. The most informative is MRI of the spine. Its price is quite high, but the examination will help to identify damage in time and avoid complications.
It is important that parents provide their child with proper nutrition and the right level of physical activity. It is necessary to protect it from jumping from a height, lifting weights and sharp bends. Then the child's spine will always be strong and he althy.
