"Kids are like lizards"

   If you've ever spent a day in clinic with me, you'll hear me say, "kids are like lizards" more than once.  I refer to the remodeling potential that pediatric bones have compared to adults.   Children are not just small adults, they are very unique in their healing potential and should not be treated like adults.  The younger a child, the more remodeling potential they have.   But before I go onto my ortho education soap box, enjoy some pictures from my life recently.  

The biggest news recently is that my business, Family and Friends Orthopedics, has found a new home and a building to call our own.  We are renovating and hope to be up and running as of October 1, 2023.  As you can imagine, this comes with a large price tag - so help me out and pay all remaining balances ASAP. :)

 As you know, in Texas, football season is the 5th season.  Spring, summer, football, fall, and winter.  During football season, I see quite a bit of pediatric trauma.  Mostly from landing on outstretched hands during falls/tackles with open physes (growth plates).  The older a child gets, the less growing they have left in their growth plates and the less deformity you can accept.  

Elle is very ready for some Glen Rose High School football.  

Some parents think I'm crazy when I tell them, "this will straighten out and heal beautifully without a surgery.  Just trust me.  Kids are like lizards."  I can understand why.  It's hard for parents to look at crooked bones and think "oh yeah, I see how that will work."

Lucky for you, I have examples.  

Crazy, right?  You don't have to be a bone doctor to see that transformation.  

What exactly do I mean by remodeling?  

• Remodeling - the reshaping of fractures (bone doctors call EVERY break a fracture) in children and straightening of bones after a hard callus is formed.  The majority of this is through the growth plate.
• A hard callus is where bone can be seen radiographically around the fracture site and this occurs between day 9-22.  This is where you get uniting of the bone ends.  
• In angulated, or displaced, fractures, children's bones more commonly return to anatomic alignment compared to those of adults.

Here's some more examples out of one of my favorite textbooks, "Fracture Healing in Children" written by David Bennett, MD and Erynn Krasovic, PA-C.   I show this book to patients and their families all the time.  

This is a Tibia in a 6 year old.   

This is a wrist in a 12 year old.

 

This is the forearm of a 6 year old.

This is the wrist of a 4 year old.

This is always a hot topic.  This is the clavicle in a 14 year old.  Look at the amount of displacement!  Those bone ends are not close to touching, but it still heals beautifully WITHOUT surgery.

The moral of this story is this - If someone tells you your kid HAS to have a surgery, it's ok to ask questions.  Sometimes kids do need a surgery for broken bones, but a lot of times they do not.  Don't be afraid of the alignment or that the bones aren't straight.  They usually get there.  

Jill McAngus, MD