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Q: My seven-year-old son has a "buckle" fracture of his collar bone. It happened almost a week ago, and he is wearing a figure 8 brace. We are having a hard time keeping him from playing and running. What should we worry about and what should we let him do? He plays soccer, and really wants to kick the ball around....he knows he can't practice or play in a game, but should we limit all activity?
A: The collar bone (clavicle) is the most frequently fractured bone in children, so you are not alone with this dilemma. More than half of all clavicle fractures occur in children under 10 years of age. Fortunately, the vast majority of collar bone fractures in kids are simple, and will heal easily with no specific therapy. Physicians tell parents to limit children's activity primarily to limit the amount of pain that the child will have. The fracture will start healing right away, and usually within a week or so you can feel a lump over the clavicle where the fracture was. This lump is from the new bone that is being laid down to help resolve the fracture. It will remodel and smooth out over the next several weeks.
For most fractures it is recommended that kids start to do some movement of the arm after the first few days. Basically, the child will decide how much activity is too much by how he or she feels. You should not feel that you have to stop him from doing all activities. Kicking the ball around is fine; you do want to limit activities that require large movements of the arm (eg swimming) for a week or two. It also makes sense to limit activities where there is a great chance of falling onto his outstretched arms ( soccer, football and hockey games), as a fall like that could disrupt the healing fracture and cause more pain. Kids heal pretty quickly though, and after 2 or 3 few weeks, he should be able to do most activities.
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Shari Nethersole is a physician at Children's Hospital, Boston, and an instructor in Pediatrics at Harvard Medical School. She graduated from Yale University and Harvard Medical School, and did her internship and residency at Children's Hospital, Boston. As a pediatrician, she tries to work with parents to identify and address their concerns.