Your child has a break (fracture) in the kneecap (patella). A broken kneecap often causes pain, swelling, and bruising. To confirm a break, X-rays or other imaging tests may be done. A splint or cast may then be put on the leg to hold the bone in place while it heals. If the injury is severe, your child may need surgery.
If your child has been given crutches, he or she should use them to walk. Your child should not walk or put weight on the injured leg until the healthcare providers says it’s OK.
Give your child pain medicine as directed by the healthcare provider. Don't give your child aspirin unless told to by the healthcare provider.
Keep the child's foot 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 the child’s leg until the foot is raised above the level of the heart. For babies and toddlers, lay the child down and place pillows under the leg 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.
Apply a cold pack to the injury to help control swelling. You can make an ice pack by wrapping a plastic bag of ice cubes in a thin towel. As the ice melts, be careful that the cast or splint doesn’t get wet. Don't place the cold source directly on the skin, because this can cause damage.
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 a 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 dry. The splint or cast should be protected with a large plastic bag closed at the top with tape or rubber bands and kept out of the water.
Encourage your child to wiggle or exercise the toes on the foot of the injured leg often.
Follow up with the child's healthcare provider, or 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 promptly.
Healthcare providers are trained to recognize injuries like this one in young children as a sign of possible abuse. Several healthcare providers may ask questions about how your child was injured. Healthcare providers are required by law to ask you these questions. This is done for protection of the child. Please try to be patient and not take offense.
Call your child's healthcare provider right away if any of these occur:
Wet or soft splint or cast
Splint or cast is too tight. Loosen a splint before calling for help.
Increasing swelling or pain, after the cast or splint is put on. Babies not yet old enough to talk may show pain with crying that can't be soothed.
Toes of the foot on the injured leg are cold, blue, numb, burning, or tingly
Child can’t move the toes of the foot on the injured leg
Redness, warmth, swelling, or drainage from the wound, or foul odor from a cast or splint
In babies, fussiness or crying that can't be soothed
Fever (see Fever and children, below)
Call 911 if your child has:
Trouble awakening or is very drowsy
Fainting or loss of consciousness
Rapid heart rate
Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.
For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.
Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.
Baby under 3 months old:
Ask your child’s healthcare provider how you should take the temperature.
Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider
Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider
Child age 3 to 36 months:
Rectal, forehead (temporal artery), or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider
Armpit temperature of 101°F (38.3°C) or higher, or as directed by the provider
Child of any age:
Repeated temperature of 104°F (40°C) or higher, or as directed by the provider
Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older.
© 2000-2020 The StayWell Company, LLC. 800 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.