Open Finger Fracture (Child)

Home care

• The doctor may prescribe an oral antibiotic to prevent infection. Follow instructions for giving this medicine to your child. Don't stop giving your child this medicine until you have finished the prescribed course.

• Give your child pain medicines as directed by the doctor. Don't give your child aspirin unless told to by a doctor.

• Keep your child's hand raised (elevated) to reduce pain and swelling. This is most important during the first 48 hours after injury. As often as possible, have the child sit or lie down and place pillows under their hand until it's raised above the level of the heart. For babies and toddlers, lay the child down and place pillows under the hand until the injury is raised above the level of the heart. Be sure the pillows don't move near the face of the baby or toddler. Never leave the child unsupervised.

• Put a cold pack on the injury to help control swelling. To make a cold pack, place ice cubes in a plastic bag that seals at the top. Wrap the bag in a thin towel. As the ice melts, be careful that the cast or splint doesn’t get wet. Don't put the ice directly on the skin, because this can cause damage. You can place a cold pack directly over a splint or cast.

• Ice the injured area for up to 20 minutes every 1 to 2 hours the first day. Continue this 3 to 4 times a day for the next 2 days, then as needed. It may help to make a game of using the ice. But don't force your child to use the ice. 

• Care for the splint or cast as you’ve been instructed. Don’t put any powders or lotions inside the splint or cast. Keep your child from sticking objects into the splint or cast.

• Keep the splint or cast completely dry at all times. The splint or cast should be covered with a plastic bag and kept out of the water when your child bathes. Close the top end of the bag with tape or rubber bands.

Follow-up care

Follow up with your child's doctor as advised. Follow-up X-rays may be needed to see how the bone is healing. If your child was given a splint, it may be changed to a cast at the follow-up visit. If you were referred to a specialist, make that appointment right away.

Special note to parents

Health care providers are trained to recognize injuries like this in young children as a sign of possible abuse. Several providers may ask questions about how your child was injured. Providers are required by law to ask you these questions. It is done for protection of the child. Please try to be patient and not take offense.

When to get medical care

Contact your child's doctor if:

• Your child's splint or cast gets wet or soft.

• Your child's splint or cast is too tight. Loosen a splint before calling for help.

• There is more swelling or pain after a cast or splint is put on the hand. Babies who can't yet talk may show pain with crying that can't be soothed.

• The injured finger, nearby fingers, or the hand becomes cold, blue, numb, burning, or tingly.

• There is redness, warmth, swelling, or drainage from the wound, or bad odor from a cast or splint.

• Your baby is fussy or crying and they can't be soothed.

• Your child develops a fever (see "Fever and children" below).

• Your child develops chills.

Call 911

Call 911 if your child has:

• Trouble breathing.

• Confusion.

• Trouble waking up or is very drowsy.

• Fainting or loss of consciousness.

• Fast heart rate.

• Seizure.

• Stiff neck.

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

• Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

• Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The doctor may want to confirm with a rectal temperature.

• Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

• Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The doctor may want to confirm with a rectal temperature.

• Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.

Use a rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the doctor what type to use instead. When you talk with any healthcare provider about your child’s fever, tell them which type you used.

Below is when to contact the doctor if your child has a fever. Your child’s doctor may give you different numbers. Follow their instructions.

When to contact a doctor about your child’s fever

For a baby under 3 months old:

• First, ask your child’s doctor how you should take the temperature.

• Rectal or forehead: 100.4°F (38°C) or higher

• Armpit: 99°F (37.2°C) or higher

• A fever of ___________as advised by the doctor

For a child age 3 months to 36 months (3 years):

• Rectal or forehead: 102°F (38.9°C) or higher

• Ear (only for use over age 6 months): 102°F (38.9°C) or higher

• A fever of ___________ as advised by the doctor

In these cases:

• Armpit temperature of 103°F (39.4°C) or higher in a child of any age

• Temperature of 104°F (40°C) or higher in a child of any age

• A fever of ___________ as advised by the doctor